Martha's Vineyard Bank Charitable Foundation Grant Application

Thank you for your interest in a grant from the Martha's Vineyard Bank Charitable Foundation! The Foundation will consider grants to nonprofit organizations operating in Falmouth or on Martha's Vineyard, for projects in the following categories:

Health and Human Need
Economic Development
Affordable Housing
Education
Elderly Services
Community Services
Special Capital Expenditure
Culture, Art and Historic Heritage
Climate and Environment

Please note the Foundation does not provide support for:

Organizations that are not tax-exempt under federal tax regulations
Political, religious, or governmental organizations
Travel expenses, including school field trips
Social functions
Individuals

At any point in your application, you may save your progress to finish at a later time by checking the option at the top of each screen.

Select Next Page below to get started with your application!

Page 2

Grant Requestor Contact Information

Contact First Name

Contact Last Name

Role in Organization

Contact Email Address

Contact Phone

Organization Information

Organization Name

Tax ID/Employer Identification Number (EIN)

Numbers only, no dashes

Mailing Address

City

State

Zip Code

Organization Website

Organization Leadership

Please list the names and titles of the organization senior leadership, including Board of Directors. Choose "Add another response" to add each additional name.

First Name

Last Name

Title

Page 3

Organization Overview

Please provide the organization's mission statement

Please provide a brief description of the organization's history, goals and accomplishments.

Employees & Volunteers

Full Time

Part Time

Volunteers

Organization Funding History

Please list any significant funding the organization has received in the past three years. Choose "Add another response" to add additional items.

Year

Funding Organization Name

Amount ($)

Page 4

Project Information

Name of Project to be Funded

Brief Description of Project

You will have the opportunity to provide more detail later in the application.

Funding Amount Requested ($)

Funds Needed By (Date)

Willing to Accept Partial Donation?

Foundation Category

This project is

Objectives

Describe the specific project objectives including whether the project targets a specific segment of the population or geographic area.

Measurement

How will the community benefit be measured? Please describe specific measurements that will be used to determine the success of the project.

Timeline

Provide a chronological work plan for the project's main activities, including completion dates.

Assistance from Foundation

Would you like to be included in the list of volunteer opportunities provided to Martha's Vineyard Bank employees?

Please provide a brief description of available volunteer opportunities.

Volunteer Contact Email Address

Page 5

Project Budget

Please provide the budgeted amount for this project in each of the categories below. Please also indicate the % of that amount that would be funded by the requested Martha's Vineyard Bank Charitable Foundation (MVBCF) grant.

At the end of this application you will have the option to upload a more detailed budget.

Facilities

% funded by MVBCF

Supplies

% funded by MVBCF

Equipment

% funded by MVBCF

Marketing

% funded by MVBCF

Contract Personnel

MV Bank Charitable Foundation does not fund salaries for organization personnel.

% funded by MVBCF

Other Expenses

% funded by MVBCF

Please explain Other Expenses.

Total Project Budget

% funded by MVBCF

Funding Sources

Please list all confirmed and potential sources of funding for the project. Choose "Add another response" to add additional funding sources.

Project Item

Amount ($)

Funding Source

Status of Funding

Page 6

Documentation

The following documents must be included with your application. If you don't have them immediately accessible, you may choose the option above to save your progress and resume later. Otherwise, please click the "Choose File" option to upload.

Please Note: Uploaded files must be in PDF format and may not exceed 5MB.

501(c)3 Certification

Most Recent Form 990

Upload Annual Report

Do you have another document you would like to provide?

Please upload one document, if you need to add another select 'Add another response'

If your application is complete, please proceed to the next page to agree to the Terms & Conditions of the grant and submit the application. You will have the opportunity to review, and make final edits if necessary, before submitting. If your application is not yet complete, please select the option to save your progress and resume later.

Page 7

Please review the following Terms and Conditions, then select "Accept" below to indicate that you are an authorized representative of the Grantee organization and that you accept the Terms & Conditions of the requested Grant.

Martha's Vineyard Bank Charitable Foundation Terms and Conditions

This Grant from the Martha's Vineyard Bank Charitable Foundation is for the explicit purposes described in the Grant Application and is subject to the Grantee's acceptance of the terms and conditions specified in this document.

Expenditure of Grant Funds

This Grant may be expended only in accordance with the Grant Application and budget as approved by the Martha's Vineyard Bank Charitable Foundation. Any modifications to the initial proposal must receive prior written authorization from the Foundation. This includes changes in the program/project, staff, funding from other sources, relationships with other agencies as well as any other material changes affecting the purpose for which the Grant was awarded. No portion of these funds may be used for purposes not clearly identified as charitable under the law.

Equipment and/or other supplies purchased with this Grant shall be the property of the Grantee as long as they are not diverted from the purpose/s for which the Grant was made. The Grantee is responsible for the expenditure of the funds and for maintaining adequate financial records consistent with generally accepted accounting practices.

Reports to the Martha's Vineyard Bank Charitable Foundation

Grantees are required to submit final narrative and financial reports relating to the purposes of this Grant to the Martha's Vineyard Bank Charitable Foundation within one year of the Grant award. The Grantee agrees to provide all of the information necessary to demonstrate that the funds have been used for the purposes intended. The requirements for these final narrative and financial reports will be provided to the Grantee by the Martha's Vineyard Bank Charitable Foundation.

Reversion of Grant Funds

At the end of the program/project supported by this Grant, the Grantee agrees to return any unexpended funds to the Martha's Vineyard Bank Charitable Foundation. The Foundation reserves the right to terminate this Grant at any time if, in its sole discretion, it determines that the Grantee has made any misrepresentations, misappropriated Grant funds, or acted in a manner inconsistent with the purposes of the Grant including any special conditions of the Grant award. At that time, all unexpended funds shall be returned to the Martha's Vineyard Bank Charitable Foundation. Funds also shall be returned to the Foundation if the Grantee loses its tax-exempt status under Section 501(c)(3) of the Internal Revenue Code or experiences bankruptcy or insolvency. The Grantee's fiscal agent also shall be bound by these terms for the reversion of Grant funds.

Nondiscrimination

The Grantee agrees that it will not unlawfully discriminate in employment practices, volunteer opportunities, or the delivery of programs or services, on the basis of race, religion, gender, national origin, age, medical condition, disability, veteran status, marital status or sexual orientation.

Public Acknowledgment

The Grantee agrees to credit the Martha's Vineyard Bank Charitable Foundation in all of the publicity relating to this program/project. This may include press releases, presentations, media coverage and the Grantee's publications and website. The Grantee agrees to notify the Martha's Vineyard Bank Charitable Foundation of any upcoming publicity or media coverage relating to the Grant.

The Grantee also agrees to cooperate with the Martha's Vineyard Bank Charitable Foundation in their efforts to highlight this Grant in their publications as well as on their websites. This may include arranging interviews and photo sessions with the Grantee's staff, board and clients, providing the Foundation with photographs, slides and graphics along with the required signed releases and providing access to background material relevant to the funded program/project.

Limit of Commitment

The Grantee acknowledges that the Martha's Vineyard Bank Charitable Foundation is under no obligation to provide additional support for this program/project or the Grantee organization. Further, it is understood that there is no commitment to, or expectation of, future funding from the Foundation.

First name

Last Name

Today's Date

Accept

By clicking "Accept" you are confirming that you are an authorized representative of the Grantee organization and accept the Terms & Conditions of the potential Grant.

Your Grant Application is now complete! Please use the option below to review your complete application. You will have the option to make final edits, or choose "Confirm" to submit your application.