HENNEPIN AVENUE UNITED METHODIST CHURCH

2011 FOUNDATION GRANT REQUEST FORM

The purpose of Foundation grants funds is to provide financial support
for church programs considered to be outside those essential for
the operation of the church and consistent with a downtown church.
Foundation funds are exclusively for funding of activity programs,
not building alterations, equipment and similar items.

Submitting Committee: Amt. Requested** $

Name of Program: Total Program Cost $

Committee Chair: Other funding sources (outside of the

church operating budget) for program
Phone No: and amounts: $

Minimum amount of funding needed

to make the program viable in some
form*** $
Staff Liaison: ** For requests greater than $1,000, please attach
(Signature)
a copy of your budget.

Approximate month of program completion: *** i.e., If the proposal cannot be funded at this
level, the program is not feasible

I. PROGRAM DESCRIPTION: [Please be as detailed as possible. Use additional space

if necessary]
Describe the program and indicate when and where it will take place (please use dates):

II. PROGRAM GOALS & OBJECTIVES:

What do you expect to accomplish? What measures will you use to assess the outcomes of this
program?

III. TARGET AUDIENCE:

How many people will this program serve? How many Hennepin members?

APPLICATION DUE DATE 10/4/10

Contact person Phone (work)

Email Phone (home)

Date Fax number

Revised 06/17/10
 HENNEPIN AVENUE UNITED METHODIST CHURCH
2011 FOUNDATION GRANT REQUEST FORM
IV. LINKAGES TO HAUMC FOUNDATION FUNDS:
Does the proposed program meet the criteria established by one or more of the HAUMC Foundation
funds? If so, please list specific fund or funds.

V. PRIOR PROGRAM EVALUATION:

If you received funding for this program or a similar program last year, please give an
evaluation/assessment of the program. What was achieved? Number of attendees or people served?
What were the relevant outcomes?

VI. How do you plan to highlight the Foundation funding during this event or program?

Please use this space to expand on any of the information requested above or provide
additional details that you deem relevant to your request.

APPLICATION DUE DATE 10/4/10

Contact person Phone (work)

Email Phone (home)

Date Fax number

Revised 06/17/10