Community Grants: Standard 2027 STANDARD GRANT APPLICATION Funding Threshold: $500 and above Use this form if your funding request is $500 or more. If your project requires less than $500, please complete our Micro-Grant Application.. Be sure to answer every question. If not applicable, mark N/A and explain. Please contact us with questions via email or at (605) 270-1596.Contact InformationProgram Name *Administrator/Director (or Agency's Primary Contact) *Email Address *Phone *Address *Apartment, suite, etcCityState/ProvinceZIP / Postal codeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweIs this person located in Lake Miner or Moody County? *YesNoLocal Contact (located in Lake, Miner or Moody County) *Email Address *Phone *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal codeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweProgram Information2027 Grant Request *How will the Community Impact Grant received in 2027 be used? Please note: facility improvements, staff wages/salary or similar projects are not eligible for funding. *0 / 250If the program received grant funding from IAUW in 2026, please give specifics as to how it was used, including a general timeline for implementation. *0 / 250Briefly describe the program. For example, does it serve a specific age group, gender or special interest? *0 / 250IAUW supports non-profit agencies and organizations that address United Way Impact Areas. Healthy Community: Improving health and well-being for all (individual health and hygiene access, nutrition and food security, health spaces and physical activity, and/or mental health support) Youth Opportunity: Helping young people realize their full potential (childcare/early childcare education, in-school, after-school and summer learning, family engagement, literacy development, and/or college and career readiness) Financial Security: Creating a stronger financial future for every generation (adult education, job training, career pathways, financial education and coaching, homelessness prevention, affordable housing, homeownership programs, and/or public benefits access) Community Resiliency: Addressing urgent needs today for a better tomorrow (crisis hotline and support, emergency preparedness, and/or disaster relief and recovery) Please choose the Community Impact Area that best describes your program. *Healthy CommunityYouth OpportunityFinancial SecurityCommunity ResiliencyPlease explain how your program applies to the selected primary Impact Area. *0 / 250Which community or communities do you serve in Lake, Miner and/or Moody counties? Please list. *For existing programs, provide the number of persons/units served.2026 Actual Persons/Units *2027 Projected Persons/Units *Please describe a unit of service, if applicable. *Do you use IAUW funds to provide scholarships? If yes, explain the application process. If not, type N/A. *0 / 250Provide examples of how a specific donation amount makes a difference for this program (for use in IAUW marketing). For example, a $90 donation to IAUW will provide 3 children free books for a year using the Dolly Parton Imagination Library program. *0 / 250For existing programs, provide at least one testimonial that shares how this program is making a difference in our area. Please include name and/or contact information if possible. You may type in or upload a file.0 / 250Upload testimonialDrag and Drop (or) Choose FilesFor existing programs, provide two refrences who can substantiate the effectiveness of this program. Please include contact information.Reference 1 *Reference 2 *Fiscal Information This section helps us understand your program’s long-term financial health and safety nets. Be sure to answer every question. IAUW reserves the right to request more fiscal information if needed.Submit your agency's most recent annual financial report or a current income/expense statement. *Drag and Drop (or) Choose FilesDoes this program have its own dedicated reserve funds, savings accounts, or trust funds? (Do not include general agency-wide operating reserves) *YesNo, this program operates strictly on its annual budgetDedicated Reserve FundsIf yes, please list belowPurpose/Source *Amount *USDAre these funds restricted for a specific use? *Yes, restricted by a donor or legal trustNo, these are unrestricted board-designated savingsBriefly explain exactly what milestone, emergency, or expense triggers the use of these savings. *0 / 250Please list the funding your agency has secured or requested from other sources for this program.Revenue Source: Government Funding (city, county, federal)2026 RequestedUSD2026 ReceivedUSD2027 Anticipated/RequestedUSDRevenue Source: Foundation & Corporate Grants2026 RequestedUSD2026 ReceivedUSD2027 Anticipated/RequestedUSDRevenue Source: Program Fees/Service Charges2026 RequestedUSD2026 ReceivedUSD2027 Anticipated/RequestedUSDRevenue Source: Special Events & Public Fundraising2026 RequestedUSD2026 ReceivedUSD2027 Anticipated/RequestedUSDRevenue Source: Other/Misc Revenue2026 RequestedUSD2026 ReceivedUSD2027 Anticipated/RequestedUSDTotal Other RevenueTotal 2026 Amount RequestedTotal 2026 Amount ReceivedTotal 2027 Amount Anticipated/RequestedWhat is the total budget for this program in 2027? *USD2027 IAUW Funding Request (from page 2) *USDPercentage of the program's total budget being requested from IAUW%Please list your planned fundraising events for 2027 and their financial goals. Attach additional sheets if necessary.Event Name & MonthFundraising GoalUSDUpload fileDrag and Drop (or) Choose FilesAgency InformationAgency Name *EIN *Mailing Address *Is this agency incorporated and does it have 501(c)(3) status?YesNoPlease upload a copy of your IRS determination letter stating your are a 501(c)(3) organization. *Choose FileNo file chosenDelete uploaded fileBecause your agency does not have 501(c)(3) status, explain what type of organization you are and how it is governed. Include an organzational chart if applicable. *Upload fileDrag and Drop (or) Choose FilesPlease list current board members. Type N/A if not applicable. *United Way Worldwide requires programs receiving funds comply with local, state and federal reporting requirements.Does your agency comply with Sarbanes-Oxley (www.soxlaw.com) provisions applicable to non-profits? *YesNoDoes your agency conduct anti-terrorism measures? *YesNoWhat is your agency's mission statement? *0 / 250Does your agency coordinate/collaborate with other programs and/or services in the community? Please explain. *0 / 250IAUW requires Community Partners commit two (2) volunteer hours to assist with IAUW efforts during the funding cycle. Volunteer opportunities may include but are not limited to: helping deliver campaign packets, selling WIN BIG Raffle tickets, working at DownTown in MadTown events, or representing IAUW in a community event.Provide names, phone numbers and email addresses for potential voluteers from your agency.NamePhoneEmail AddressApplicant SignatoryTitleDateConsent *I attest that to the best of my knowledge all of the information contained herein is correctSubmitSave as DraftPlease do not fill in this field.
