Foundation

GRANT APPLICATION GENERAL INSTRUCTIONS

The grant application has three parts. Be sure to complete each part.
All questions relative to the request must be fully completed.
Submit only one application per organization per deadline.
Do not include materials other than those specifically requested.

The Zurn Foundation Board of Directors meets semi-annually in July & January. If you would like your grant application to be reviewed at our July meeting, the cut-off date for submission of the completed application is May 1. The cut-off date for the January meeting is November 1.

Organizations will be notified if they have received a grant by the end of the month following the Board of Directors meeting each July/January. Organizations that do not receive a grant may not be notified.

If you have any questions, please email the Zurn Foundation at Zurn.Foundation@zurn.com

PART ONE: GRANT AND ORGANIZATION INFORMATION

GRANT REQUEST

Total Amount Requested

Title of Request

Duration of Request: from

Please enter a value.

Nature of Request

Capital Project Operating Program Endowment Other

In what geographical location will the funds be used?

ORGANIZATION INFORMATION

Name

Address

Phone Number

Web Address

Dates of organization's fiscal year

Organization's total operating budget for past year

and current year

Chief Staff Officer

Name

Title

Phone Number

Email Address

Person Submitting Request

Name

Title

Phone Number

Email Address

Board Chairperson

Name

Employer

Phone Number

Email Address

Please list the organization's staff composition in numbers:

Paid Full Time

Paid Part-Time

Volunteers

Has your organization's governing board approved a policy which states that the organization does not discriminate as to age, race, religion, disability, sexual orientation, sex, or national origin?

Yes No

Does the organization have federal tax-exempt status?

Yes No

Population Served

Please check the primary service category of organization

Arts/Culture Health Human Services Civil/Economic Development Education Environment Other

Provide percentages and/or descriptions of the populations the organization serves:

African-American

Caucasian

Native American

Asian American

Hispanic/Latino

Other

Please list all known Zurn Elkay associates who provide financial support to your organization.

Please list any Zurn Elkay associates who serve on your Board of Directors or in other leadership positions within your organization.

Authorization

Has the organization's chief executive officer endorsed this request?

Yes No

An officer of the organization’s governing body (such as a board member) must endorse this application. To do so, copy and paste the text below on organization letterhead and have a board member sign and date. Then scan and upload that document in Part 3 of this application.

The undersigned, an authorized officer of the organization, does hereby certify that the information set forth in this grant application is true and correct, that the Federal tax exemption determination letter attached hereto has not been revoked and the present operation of the organization and its current sources of support are not inconsistent with the organization’s continuing tax-exempt classification as set forth in such determination letter.

You must enclose all required supporting materials with the application (see Part Three).

PART TWO: GRANT PROPOSAL NARRATIVE

Please provide the following information. Note that some sections are not required for General Operating Support. Refer to the Glossary of Terms as needed when preparing the narrative.

Organization Information and Background

Provide a brief summary of the organization’s mission, goals, history, programs, and major accomplishments, success stories and qualifications.

Show evidence of client and community support.

Project/Program Description (NOT required for general operating requests)

Abstract: Briefly describe the proposed program, how it relates to the organization’s mission, capacity to carry out the program, and who will benefit from the program.

Explain the significance of the program and why the organization is qualified to carry it out.

Describe the expected outcomes and the indicators of those outcomes.

Document the size and characteristics of the population to be served by the program.

Outline the strategy/methodology and timeline to be used in the development and implementation of the program.

What is the plan to involve the population you intend to serve in the design?

How does this program enhance the existing services in the community?

Evaluation

Briefly describe the program evaluation process.

Explain how the organization will measure the effectiveness of the program.

Describe the criteria for success.

Describe the results expected to be achieved by the end of the funding period.

Funding Considerations

Describe plans for obtaining other funding needed to carry out the project/program or organizational goals, including amounts requested of other funders.

If the project/program is expected to continue beyond the grant period, describe plans for ensuring continued funding after the grant period.

List the top five funders of this project (if applying for a Program Grant) or organization (if applying for General Operating Support) in the previous fiscal year, the current year, and those pending for the next fiscal year.

PART THREE: REQUIRED ATTACHMENTS

Submit the following attachments with the completed proposal:

1. Complete list of the organization's officers and directors.

Please select a file

2. The organization’s most recent audited financial statement including notes and IRS Form 990.

Please select a file

3. The organization’s projected income and expense budget for the current fiscal year, identifying the projected revenue sources.

Please select a file

4. Copies of the IRS federal tax exemption determination letters.

Please select a file

Foundation Grant Application

GRANT APPLICATION GENERAL INSTRUCTIONS

PART ONE: GRANT AND ORGANIZATION INFORMATION

GRANT REQUEST

ORGANIZATION INFORMATION

Population Served

Authorization

PART TWO: GRANT PROPOSAL NARRATIVE

Organization Information and Background

Project/Program Description (NOT required for general operating requests)

Evaluation

Funding Considerations

PART THREE: REQUIRED ATTACHMENTS