Community Grant Application – Keta Legacy Foundation

If you think your project falls within our guidelines, please complete the application form below. Most fields are required: we do not accept incomplete applications.

Please note that many mobile devices do not permit file uploads: you will need a computer to complete your grant application.

Applicant*
(Organization or Individual)
U.S. Federal Tax ID*
Are you a 501(c)3?*
Contact Name*
The person we should contact with respect to this application.
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax (optional)
Email*
Website (optional)
Project Lead*
Please enter the name of the person who will be running the project.
Applied to other sources?*
- Yes
- No
Have you applied elsewhere for funds for your project?
Received funds from other sources?*
- Yes
- No
Have you been awarded funds form other organizations for this project?
Total Project Cost*
Please enter the total cost of your project as a number rounded to the nearest dollar without a dollar sign, i.e. $100,000.15 enter as 100,000
Amount Requested*
Please enter the amount of your request as a number rounded to the nearest dollar without a dollar sign, i.e. $100,000.15 enter as 100,000
Percentage of Total*
Please enter a value between 1 and 100.

Enter up to a 3 digit number representing the percentage of the total project cost you are requesting us to fund, rounded to the nearest whole percentage.
If not funded?*
Please write a brief explanation of what you will do if you don't receive the total amount requested.
Overhead costs*
Please provide a statement of who will pay the overhead costs of this project.
Acknowledgment*
How will the Keta Legacy Foundation be acknowledged? We expect public acknowledgment of our grant. How and when will you do this?

(Please note that the Mountaineers Foundation is doing business as Keta Legacy Foundation. We are NOT the same organization as The Mountaineers Club)
Summary*
Please provide a brief, one paragraph summary of the specific project or component for which you request funds, including the specific use of The Foundation grant monies.
Narrative*
Accepted file types: pdf, doc, docx.
Upload a short (4-page maximum) narrative telling us about:
- • your organization's mission
- • exactly what you propose to do; why it is important; how it addresses the Foundation's priorities; what outcomes you expect to achieve
- • who will do the work; include either resumes or short narrative descriptions of qualifications
- • a project schedule, including regular progress reports to the Keta Legacy Foundation
Financial Statement*
Accepted file types: pdf, doc, docx, xls.
Upload your organization's most recent financial statement (please do not send audit reports or IRS filings).
Project Budget*
Accepted file types: pdf, xls, doc, docx.
Upload a specific detailed budget for this project, including cash flow, which shows how the Keta Legacy Foundation funds, and the funds you have requested from others, will be spent.
Letter of Support (optional)
Accepted file types: pdf, doc, docx.
Evidence (e.g., a letter) of commitment from any organization you have included in your project's work scope. (Optional)
503(c) IRS Letter*
Accepted file types: pdf.
PDF copy of your letter of determination from the IRS.
Name
This field is for validation purposes and should be left unchanged.