Fillable Waipahu Grant Application Form 201112 (Bank of Hawaii)

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Waipahu Grant Application Form 201112 (Bank of Hawaii)

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WAIPAHU COMMUNITY
FOUNDATION
GENERAL INFORMATION
AND
GRANT APPLICATION FORM
(Revised December 2011)
Revised 12/2011
1
GENERAL INFORMATION
Background: These basic guidelines are in keeping with the wishes of Waipahu
Community Foundation’s leading proponent and founder, Mr. Kenneth Nakamura, then
President of the Herbert Horita Development Corporation. Mr. Nakamura intended that
every Waipahu youth have the opportunity to access and participate in community
cultural, education and recreation programs. He felt strongly that all youth should be able
to participate in all programs offered regardless of his or her ability to pay fees. The
Waipahu Community Foundation has been made possible with monies contributed to a
perpetual Trust by H K Horita Realty Inc, Royal Oahu Resorts, Inc. and Hazama
Corporation in 1992-93. This contribution was part of the bilateral agreement negotiated
by the City and County of Honolulu and developers of the Royal Kunia Golf Course.
Grant Purpose - Grants are intended to be used to benefit Waipahu’s youth primarily but
not exclusively for the following purposes:
• Programs/projects that benefit elementary, intermediate, and high schools in
Waipahu;
• Programs/projects that combat juvenile delinquency in Waipahu, including youth-
related activities and anti-drug, crime prevention, and recreational programs or
activities;
• Health-related programs in Waipahu that provide rehabilitation and counseling;
and
• Cultural programs or facilities in Waipahu that promote cultural education.
Eligibility Requirements - All applicants for funding shall meet the following standards:
• Be an internal Revenue Service (IRS) approved charitable 501( c)( 3) tax exempt
organization (but not a private foundation) or a unit of government based or
conducting business or a program in the Waipahu area identified by postal zone
ZIP code) 96797.
• Have a governing board whose members have no material conflict of interest and
serve without compensation and by-laws that specify policies that describe the
manner in which business shall be conducted.
Funding Restrictions - Funds received from the WCF may not be used for:
• Personal expenses for adults (i.e. travel, per diem, clothing, etc.)
• Independent contracting (paying someone else to provide services)
• Capital improvements such as building renovation, maintenance of facilities or
other major capital expenditures such as facility construction
• Activities begun prior to the Award program/project period
• Deficit funding (i.e. existing debt or other prior existing budget shortfalls)
• Fundraising (i.e. front cash for chili or other food ticket sales)
• Equipment purchase costing $1000.00 or more per item (exceptions may be
considered by the Foundation’s Board of Directors)
• Personal travel (restriction does not apply to local youth group travel such as bus
rental for school group educational excursions associated with a funded activity)
Revised 12/2011
2
• Banquets (restriction does not apply to food, drinks or refreshments related to an
approved program or activity not exceeding 10% of the program or activity cost)
• Off island travel
Guidelines for Project Graduation: Project Graduation applicants will request funds to
“provide scholarships for students to attend Project Graduation.” The final report will
include an expense report/summary and the names and addresses of students receiving
the scholarships.
Review Procedure - The Waipahu Community Foundation Board of Directors will
conduct a thorough review of all grant requests received. The Board will recommend
those to be funded in accordance with funds available and procedures set forth in this
document. Consideration will be given, but not restricted to, the following items:
• Eligibility of organization
• Purpose of program or activity
• Accuracy and thoroughness of information provided by applicant
• Need in the community for the proposed program or activity
Grant Distribution:
• Grants are awarded either annually or quarterly.
• Organizations eligible for the annual award program may also apply for one
quarterly grant each fiscal year (July to June).
• Applicants may be awarded no more than two grants each fiscal year (July 1
st
–
June 30
th
).
Note: In order to help the Foundation evaluate the effectiveness of grants, each grantee
must submit a report detailing how the grant funds were expended (for detailed
instructions please refer to the Reporting Guidelines). An applicant for either an annual
or a quarterly grant must have submitted the required report for any prior grant, and the
report must have been reviewed and approved by the Foundation, before a successive
application can be considered. However, the Foundation Board may consider and
approve applications for a quarterly grant from a prior recipient of an annual grant as
long as the annual grant reporting deadlines are met (i.e., either the required report for
the activity funded by the annual grant has been submitted and approved or the project is
still ongoing and/or the required report is not past due). Applicants for quarterly grants
should bear in mind that time constraints will normally preclude consideration of
applications in consecutive quarters and plan accordingly.
Annual Program: 50% of designated funds for each fiscal year are set aside for
five charter member organizations set forth below with grant amounts not to exceed the
percentages noted. (The full 50% may not be awarded.) Each organization must submit
the standard application which is reviewed in the same manner as all applicants. Original
plus 12 copies of the application material are due by 10 June.
• Waipahu High School 50%
• Friends of Waipahu Cultural Garden Park 20%
Revised 12/2011
3
• Waipahu Jackrabbits Association10%
• Village Park Athletic Association (Pop Warner Little Scholars) 10%
• Leeward Oahu YMCA 10%
Quarterly Program: Remainder of funds available will be awarded in four (4)
quarters: Original plus 12 copies of the application material are due by 1
st
Friday of
month prior to award period.
• 1
st
Friday in June for 1
st
quarter (July, August & September)
• 1
st
Friday in September for 2
nd
quarter (October, November & December)
• 1
st
Friday in December for 3
rd
quarter (January, February & March)
• 1
st
Friday in March for 4
th
quarter (April, May & June)
• Grant awards are limited to $5,000.00 per quarter per applicant.
Note: Applicants selected to receive WCF grant funding, whether annual or quarterly,
will be notified by letter by first day of quarter for which awards are made. Checks will
be provided at a quarterly award ceremony. By cashing the award check, each grantee
agrees to abide by the all the conditions stipulated in the notification letter and its
enclosed Reporting Guidelines.
Grant Application Procedure: Applications should be informal, brief, and present the
facts required by the General Information Section. The application, no more than three
pages, should include the following information:
• Brief description of requesting organization and its purpose
• Concise summary of the proposed program or project
• Total cost of the program/project and funding sources
• Qualifications of person(s) responsible for executing the program/project
• Provide all information requested on the grant application forms. Do not refer to
attachments. The only attachments required are proof of non-profit status and
your organizational papers. (Refer to the following.)
Additional Document Requirements - All applicants shall submit the documents listed
below. If copies were submitted with a previous grant application and there have
been no changes, another copy does not need to be submitted. (Please check the
appropriate box on the application form, Item 1.)
•
If not a unit of government, a copy of the applicant’s tax exempt status letter from
the IRS.
• A copy of the organization’s by-laws, articles of incorporation and/or policy
statements.
It is strongly recommended that applicants use the attached grant application form.
If it is not adequate, be sure to follow the format of the application form.
Your grant proposal should be addressed to the President of the Waipahu Community
Foundation, ℅ Waipahu High School Administration Office, 94-1211 Farrington
Highway, Waipahu, Hawaii 96797. Phone the Waipahu High School principal at 528-
9555 if additional information is needed.
Revised 12/2011
1
Waipahu Community Foundation
Grant Application Form
(Requested information is required by the Foundation’s governing documents))
1. Date of Application:
2. Applicant: ___________________________________________________________
Name of Applying Organization
_________________________________________________ Waipahu, HI 96797
Street Address
Principal Administrative Officer: _____________________________________ ________________
Name Phone Number
3. Grant Information:
Type of Grant: (check one): Annual Quarterly
4. Program/Project Title: _________________________________________________
5. Proposed Program/Project is (check one):
a. An ongoing activity that has received previous funding by WCF
• How many years funding received from WCF for this program/project? _____
b. A program/project that has not received previous WCF funding
6. Eligibility: Applicant is (check one):
Unit of Government (e.g., public school); or
Tax-exempt under IRS 501(c) (3)*; or
Under a group exemption* (please attach supporting documentation)
7. Previous grant status (check one):
Prior WHF grant received (most recent month/Year: ______/______)
Prior grant report submitted** (please check one) yes no
First-time applicant for WCF funding (please attach copy of IRS 501
(c)(3) determination letter*, organization’s by-laws, articles of
incorporation and/or policy statements).
* Tax-exempt status will be verified by Foundation’s trustee, Bank of Hawaii.
** Please see “Note” on page 2 above (General Information)
6. Organization Description:
a. Year established or began operations in Waipahu: _______________
b. Organization’s purpose (quote from mission statement if available):
Revised 12/2011
2
c. Major activities
d. Staffing/organization management description to include board members:
(check here if additional information is included on a continuation sheet)
9. Program/Project description:
a. Dates of Program/Project (Note: must begin within quarter for which grant is
issued; actual program completion date may extend beyond the end of the quarterly
grant period, but all expenditures must be made before the end of said period):
Beginning _______/_______ Completion _______/_______
month year month year
If program/project completion date is expected to be beyond end of quarterly grant
period, explain why:
b. Size of target group (how many Waipahu youth are expected to benefit?): ________
c. Goals/Objectives (What will the grant be used to do?):
d. Outcomes (What will be the result of your program/project?):
e. Criticality/Need (What will happen if the program/project isn’t funded?):
f. Evaluation (how will the success of this program/project be evaluated and by
whom?):
Revised 12/2011
3
10. Proposed Program/Project Budget ( continuation sheet is attached): NOTE:
Use of funds must be as specified in this grant proposal. Variances of more than $250
from the proposed budget must be documented in the Activity and Financial Report.
Item/Expense Description Cost WCF Share
(if more than 1 of same item, indicate how many)
Sub-totals
11. Proposed Program/Project Funding (cash and in-kind) ( continuation sheet is
attached):
Sources of Funds Cash Revenue***
Sub-totals
***Refers to fees/charges collected in association with activities (e.g., registration fees)
Sources of In-Kind Contributions Description Estimated Value
Sub-total
12. Summary: Total WCF Funds Requested: $__________ Other funding $_________
13. Certification: I/we certify that the above information is correct to the best of my/our
knowledge and belief. This application has been duly authorized by the applicant’s
governing body.
Authorizing official(s): ______________________ ___________________ __________
Printed Name Signature Date
______________________ ___________________ __________
Printed Name Signature Date
NOTE: As part of the grant application review process applicants may be contacted by
individual board members to reconcile/resolve any questions or perceived problems with
the application.
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Waipahu Grant Application Form 201112 (Bank of Hawaii)

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Completed 31 January 2021

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