POTLATCH FUND - NPAIHB › images › resources_docs › weeklymailout... · Potlatch Fund aims to inspire and build upon the Native tradition of giving and to expand philanthropy

801 Second Avenue, Suite 304 Seattle, WA 98104 206-624-6076 www.potlatchfund.org

POTLATCH FUND

INSPIRING THE NATIVE TRADITION OF GIVING

Spring Grant: 2013 Native Arts Application Form

Potlatch Fund is excited to announce the 2013 Native Arts Grant Cycle to benefit individual Native Artists and/or organizations in arts and cultures in the Washington, Oregon, Idaho, and Montana. Grants will be awarded in amounts ranging from $500 to $5,000. Potlatch Fund aims to inspire and build upon the Native tradition of giving and to expand philanthropy within Tribal Nations and Native communities in the Northwest.

The name, Potlatch Fund, reflects a Northwest Coastal Tribal traditional ceremony and in the Chinook language Potlatch means to give, or, a gift. Potlatches are a continued tradition where individuals share their good fortune through the distribution of gifts to members of their Tribes as well as those of neighboring Tribes.

Native art has always been integral to every aspect of Tribal life. In Tribal culture, art is not separate from everyday life, but rather art is the center of Tribal life and everyday objects and tools are decorated beautifully with designs that perpetuate Tribal identity, culture, and knowledge. This year funding priority will be given to projects from individual Native artists, Native arts organizations, or Tribal museums who are working to revitalize endangered Native art forms, practices, and knowledge through intergenerational opportunities that transfer knowledge from elders and cultural retainers to a new generation.

Who is eligible to apply?

The individuals/ organization must be Native‐led.

The individuals/ organization must be located in the States of Washington, Oregon, Idaho or Montana.

The individual/ organization's mission must be aligned with the mission of Potlatch Fund.

The individual /organizations that have previously received a Potlatch Fund grant, may only apply to this grant cycle if they have completed all past reporting obligations.

Organizations may only receive funding for one Potlatch Fund grant per calendar year.

Applications from different departments, from within a Tribe, will be reviewed as separate organizations. Please note: We do not retroactively fund project work. How to apply

Complete and submit this application with all attachments. The certification page must be signed and mailed, faxed, or scanned along with your application.

Email to:

[email protected] or fax to:

206.264.7629 or mail white 8 ½” x 11” paper, to:

Potlatch Fund Attn: Native Arts 801 Second Ave, Suite 304 Seattle, Washington 98104

Applications must be received or postmarked by Friday, April 26, 2103.

For questions please contact the Office Manager at 206.624.6076 ext 10 or email [email protected].

Late proposals will not be accepted.

Potlatch Fund Application FormSPRING GRANT: 2013 Native Arts

Attachments (Please include ALL of the following items with your application)Items must be submitted by:attaching and emailing the documents with the completed application orprint and fax to 206.264.7629 or print and mail to: 801 2nd Ave Suite 304, Seattle, WA 98104p p , ,

Individual

Application for Native Arts Grant (This Form)

Resume which describes your accomplishments and background

Proof of Tribal enrollment or Tribal affiliation

l f d f k l dTwo letters of recommendation from key Native leaders in your community

Samples from your art portfollio

Current year's Individual Budget You may use the template in the application or submit your own

Provide appropriate documentation of your work. Potlatch Fund cannot return this documentation to applicants.

American Indian Tribal Government

Application for Native Arts Grant (This form)

Indicate, on the application, that you are a federally recognized Tribal Government or Agency

***If you are being sponsored by a Tribal Government or Agency, attach a signed statement from

them agreeing to serve as your sponsor and stating their support for your project

Two letters of recommendation from key Native leaders in your communityTwo letters of recommendation from key Native leaders in your community

Samples from your art portfollio/project

Current year's Organizational Budget You may use the template in the application or submit your own

Provide appropriate documentation of your work.

Potlatch Fund cannot return this documentation to applicants.

Native led 501(c)3 Organization

Application for Native Arts Grant (This Form)

501(c)3 Letter

***If you are sponsored by a Native led nonprofit, attach their 501(c)3 letter with a signed statement from

them agreeing to serve as your sponsor and stating their support for your project

Two letters of recommendation from key Native leaders in your communityTwo letters of recommendation from key Native leaders in your community

Samples from your art portfollio/project

Current year's individual/ organizational Budget (provided in application or you may submit your own)

Provide appropriate documentation of your work.

Potlatch Fund cannot return this documentation to applicants.


1) Organization/Individual Contact Information

Artist Name:

Tribal Affiliations:

Website:Website:

Mailing Address:

City: State: Zip:

Organization:

Grant Contact: Title:

eMail Address: Alternate eMail:

Phone: Fax:

O h PhOther Phone:

Organization Status:

Federally Recognized American Indian Tribal Government

Tribally sanctioned 7871 organization

Native led 501(c)3organization as recognized by the IRS

If yes, EIN#

Fiscally Sponsored by a federally recognized Tribe, or a Native led 501(c)3, or a 501(c)4Fiscally Sponsored by a federally recognized Tribe, or a Native led 501(c)3, or a 501(c)4

Fiscal Sponsor Contact Information (if applicable):

Name:

Mailing Address:

City/State/Zip: Email:

Contact Person/ Title:

Phone:

EIN#:

2) Organizational Financial Information

Project Title:

Where will the project take place?

When will the project begin?

When will the project be completed?When will the project be completed?

Grant Amount Requested:

Total Individual Budget (if applicable):

Total Organizational Budget (if applicable):

Total Project Budget:

3) Project Information

Which communities will be served? (Please check ALL that apply)Which communities will be served? (Please check ALL that apply)

Rural Elders On‐Reservation

Urban Women Off‐Reservation

Regional Youth

Which issues does your work focus on? (please check ALL that apply)

Cultural Preservation Health

Education Substance Abuse PreventionEducation Substance Abuse Prevention

Environmental Preservation Language Preservation

Potlatch Fund Application Form SPRING GRANT: 2013 Native Arts

4) Project Narrative

Please answer the following questions in the order listed below with 12 point font, single spaced. Click on f g q p f g p

the top left corner of the translucent box to access the space provides.

1) Summarize this grant request (50 word maximum)

2) Describe how your work connects to your community.

Describe the impact of the project on the community.

3) How will this grant advance your organization's artistic expression?

How will this grant advance your personal artistic expression and/or art career?

4) Describe the goals of your work or your arts organization.

Describe your long‐term vision for promoting and strengthening Northwest Native art.

5) Please describe the results of your project:

How will you determine that it is a success?

If you do not receive all the funding you request, can you still do the project?

6) What is your experience or the experience, mission, history and expertise of your organization's staff,

board, and volunteers relating to this grant request?

7) Explain how your project will revitalize endangered Native art forms, practices, and knowledge through

intergenerational opportunities that transfer knowledge from elders and cultural retainers

to other generations through workshops, master / apprentice opportunities, etc.

8) What else do you want us to know about you, your organization or your project, if anything?

*** Strong proposals will demonstrate the use of Native resources and indigenous knowledge


Project Funding Proposed Budget Is income

Confirmed or

INCOME Provide details INCOME INKIND Anticipated?

Tribal Support** $$

Foundation Support** $Foundation Support** $$

Corporate Support** $ $Individual Support** $

$Other earned income $

$** Support should include donations, grants, sponsorship, etc Support should include donations, grants, sponsorship, etc

Estimated Total Project CASH INCOME $

EXPENSES Provide details CASH INKIND

Salaries and wages (break down by individual position and indicate full or part time): $ $Employee 1 $ $Employee 2 $ $Employee 3 $ $Consultant 1 $ $Consultant 2 $ $

$ $Supplies $ $

$ $$ $$ $

Space Rental $ $Travel (Mileage) $ $Postage and delivery $ $

$ $Other Expenses $ $

$ $

Estimated Total Project CASH EXPENSES $

Current Year Operating Budget [annual totals] Year Ends on :

Income $:Expenses $:


Please list all Tribal Council Members or Board Members and Staff Tribal Council Members or Board Members

l l b l ff lFirst Name Last Name Title Email Tribal Affiliations

1

2

3

4

55

6

7

8

9

1010

11

12

13

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1515

16

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20

Staff

First Name Last Name Title Email Address Tribal Affiliations

1

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5

6

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15

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19

20


Please read, print, and sign this last page of the application. Return the signed document to Potlatch Fund by scanning and emailing the document with the completed application to [email protected] or fax to

206.264.7629 or mail to: 801 2nd Ave, Suite 304 Seattle WA 98104

206.264.7629 or mail to: 801 2nd Ave, Suite 304 Seattle, WA 98104

CERTIFICATION: I hereby certify that the information included in this application is true and correct.

If awarded funding from Potlatch Fund, I certify that funds will be used solely for the purposes outlined in this grant application and that the organization will obtain Potlatch Fund’s approval if the project’s purpose, timeline, or budget are significantly modified.

Under United States law, Potlatch Fund grant funds may be expended only for charitable, scientific, literary, or educational purposes. In accordance with this law, if awarded funding, I certify that my organization/group will not promote or engage in violence terrorism bigotry or the destruction of any State nor will it make sub

Under United States law, Potlatch Fund grant funds may be expended only for charitable, scientific, literary, or educational purposes. In accordance with this law, if awarded funding, I certify that my organization/group will not promote or engage in violence, terrorism, bigotry or the destruction of any State, nor will it make sub grants to any entity that engages in these activities.

If awarded funding from Potlatch Fund, I agree to indemnify and hold Potlatch Fund harmless from and against all liability, damages, claims or expenses (including reasonable attorneys’ fees) arising from the project or as a result of the acts or omissions of Grantee, its employees, consultants, contractors or agents in connection with said program or otherwise.

I also certify that, if awarded funding, my organization/group will acknowledge, wherever possible, Potlatch

Signature of Artist Title, if other than Artist Date

or Organizational Representative

connection with said program or otherwise.

I also certify that, if awarded funding, my organization/group will acknowledge, wherever possible, Potlatch Fund’s support of the project or program. Finally, if awarded funding, I also agree to submit a written final report.


Print Name of Artist Organization


Signature of Fiscal Sponsor Representative Title Date

(if applicable)

Print Name of Fiscal Sponsor Representative Organization

(if applicable)

Important Notes

A final written report is to be furnished at the end of the grant period: Friday, February 7, 2014.

Potlatch Fund may monitor and conduct a review of operations under this grant, which may include a visit


Potlatch Fund may monitor and conduct a review of operations under this grant, which may include a visit from Potlatch Fund personnel to observe your program, discuss the program and finances with your personnel and review financial and other records and materials connected with the activities financed by the grant.

Potlatch Fund is authorized to conduct audits, including on‐site audits, at any time during the term of the grant.

Potlatch Fund will include information on this grant in its periodic public reports. Potlatch Fund may also refer to the grant in a media release, in which case a copy would be sent to you in advance. If you wish to make your own media announcement, please consult with Potlatch Fund.

Potlatch Fund will include information on this grant in its periodic public reports. Potlatch Fund may also refer to the grant in a media release, in which case a copy would be sent to you in advance. If you wish to make your own media announcement, please consult with Potlatch Fund.


POTLATCH FUND


Spring Grant: 2013 Language Preservation and Education Fund Application Form

Potlatch Fund is excited to announce the 2013 Language Preservation & Education Fund grant cycle to provide general or project support for Native organizations and Tribal departments working within Native communities to preserve Native languages. Grants will be awarded in amounts ranging from $500 to $5,000. Potlatch Fund aims to inspire and build upon the Native tradition of giving and to expand philanthropy within Tribal nations and Native American communities in the Northwest. The name, Potlatch Fund, reflects a Northwest Coastal Tribal traditional ceremony and in the Chinook language Potlatch means to give, or, a gift. Potlatches are a continued tradition where individuals share their good fortune through the distribution of gifts to members of their Tribes as well as those of neighboring Tribes. With the help of a new donor we are excited to offer this grant cycle in support of language preservation and documentation efforts, educational enrichment and after school Native youth programming, and the professional development of Native educators. This initiative is important because we know that Native languages provide connections to our culture, history, and traditions and yet, with only limited numbers of fluent speakers, too many of our communities are at risk of losing their language. This grant fund also supports the advancement of Native educators and Native youth programming to foster the inclusion of cultural identities in educational environments. Who is eligible to apply?

The organization must be Native led and serve Northwest Natives.

The organization must be located in the Washington, Oregon, Idaho or Montana.

The organization’s mission must be aligned with the mission of Potlatch Fund.

Organizations that have previously received a Potlatch Fund grant, may only apply to this grant cycle if they have completed all reporting obligations.


Applications from different departments, from within a Tribe, will be reviewed as separate organizations. Please note: We do not retroactively fund project work.

How to apply


Email to:



Potlatch Fund Attn: Language Preservation and Education Fund 801 Second Ave, Suite 304 Seattle, Washington 98104

Applications must be received or postmarked by Friday, April 26, 2103

For questions please contact the Office Manager at 206.624.6076 ext 10 or email [email protected]


Potlatch Fund Application FormSPRING GRANT: 2013 Language Preservation & Education Fund

Attachments (Please include ALL of the following items with your application)Applications may be submitted by:

eMailing the complete application to [email protected], or

printing and faxing the complete application to 206.264.7629, or

printing and mailing the complete application to: 801 2nd Ave, Suite 304 Seattle, WA 98104

Cover letter

Completed Application

Signed Certification Page

Official letter of support (or resolution) from the Tribe authorizing the applicant's project

Previous year's organization and project financial statements (four pages maximum)

Check only one of the following:

Are a federally recognized American Indian Tribal Government or section 7871 organization:

A list of Tribal Council Members in the Grant Application

Are a Native‐led 501 (c) 3, or 501 (c) 4 attach:

Verification of your IRS approved tax‐exemption status

A list of Board Members and Staff in the Grant Application

Have a federally recognized Native American Tribal fiscal sponsor,

please state so in your cover letter, and attach:

A signed letter (on their letterhead) supporting your application

and agreeing to serve as your fiscal sponsor

A list of their Tribal Council Members in the Grant Application

Have a 7871, 501 (c) 3, or 501 (c) 4 fiscal sponsor, state so in your cover letter and attach:

Verification of their IRS approved tax‐exemption status



A list of their Board Members and Staff in the Grant Application

Applications must be received or postmarked by Friday, April 26, 2013For questions please contact the Office Manager at 206.624.6076 ext 10 or email [email protected]


1) Organization Contact Information

Organization Name:

Website:

Address:

City: State: Zip:

Contact Name: Title:


Tribal Affiliation:

Phone: Fax:

Other Phone:




501(c)3 organization as recognized by the IRS If yes, EIN


Fiscally Sponsored by a federally recognized Tribe, a 501(c)3, or a 501(c)4


d l l dAmount Requested: Total Organizational Budget:

Total Project Budget: Project Name (if applicable):

When and where does the project take place? ________________________________________________


Which communities will be served? (Please check ALL that apply)



Regional Youth


Cultural Preservation Health Civic Participation

Education Language Preservation Economic Development

Environmental Protection Youth Empowerment

ich Native language(s) will your program/project focus on?

What Tribal communities will your work impact?

Potlatch Fund Application Form SPRING GRANT: 2013 Language Preservation & Education Fund


Please answer the following questions in the order listed below with 12 point font, single spaced. Click on the

top left corner of the translucent box to access the space provided.

your program/project is utilizing, what types of materials will be collected &/or produced,

and how to you plan to share your work with your Tribal partner.

‐ complete mission, purpose, when organization was started

‐ history of accomplishments

1) Summarize this grant request including the types of language preservation and/or educational approaches

2) Organizational Background

Please include the following information:

3) How does your service (How will your project) positively impact the Native community you serve?

4) What will you do with the funds requested? And who will be served by your organization/ project?

***Describe the goals of your organization if you are applying for general support***

***Describe the project goals if you are applying for support of a specific project***

5) What would your organization do if only partial funding was available?

What aspect of the project would you fund first?

6) Why is your organization the best group to provide this service/ undertake this project?

7) List the people who are part of your organization or team.

***What are their roles and Tribal affiliations?***

***Who will be responsible for completing the work related to this grant?***

8) What else do you want us to know about your organization?8) What else do you want us to know about your organization?

10) When do you expect to accomplish the goals of your project?

If requesting funds for a specific project, please include answers to the following questions.

9) How will you know if your project has succeeded?

What will success look like?


5) Project Funding Proposed Budget Is income

Confirmed or

INCOME Provide details CASH Anticipated?

Government Grants** $ and Contracts $Tribal Support** $

$Foundation Support** $

$Corporate Support** $ $Individual Support** $

$Inkind Support** $


$** Support should include donations, grants, sponsorship, etc



Salaries and wages (break down by individual position and indicate full or part time): $ $E l 1 $ $Employee 1 $ $Employee 2 $ $Employee 3 $ $Consultant 1 $ $Consultant 2 $ $

$ $Supplies $ $

$ $$ $

Rental and utilities $ $Travel $ $Postage and delivery $ $Printing and Copying $ $Telephone and Fax $ $Inkind Expenses $ $Other Expenses $ $

$ $

Estimated Total Project CASH EXPENSES $ $

Current Year Operating Budget [annual totals]Year Ends on :



6) Fiscal Sponsor Contact Information (if applicable):

Applicant Organization Name:

Fiscal Agent Organization Name:

Mailing Address:

City:

State: Zip Code:

Phone:

Fax:

Website:

Fiscal Agent Contact Name:

Title:

Phone:

eMail Address:

Fiscal Agent Information Fiscal Agent Budget

Incorporation Date: Year Ending:

EIN #: Income $

State UBI #: Expenses $


7) Please list all Tribal Council Members or Board Members and Staff

Tribal Council Members or Board Members

First Name Last Name Title Email Tribal Affiliations

1

2

3

4

5

6

7

8

99

10

11

12

13

14

15

16

17

18

19

Staff


1

2

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Signature of Organizational Representative Title Date

Print Name of Organizational Representative Organization








(if applicable)


(if applicable)

Important Notes

A final written report is to be furnished at the end of the grant period: Friday, February 7, 2014



Potlatch Fund will include information on this grant in its periodic public reports. Potlatch Fund may also refer to the grant in a press release, in which case a copy would be sent to you in advance. If you wish to make your own press announcement, please consult with Potlatch Fund.

Failure to comply with the terms of this grant application may result in immediate cessation of support from Potlatch Fund. In addition, if your organization expends or commits any part of the grant funds for purposes or activities other than the purposes and activities for which this grant is made, your organization must repay Potlatch Fund an amount equal to the amount of grant funds so expended for other purposes or activities.


POTLATCH FUND


Spring Grant: 2013 Community Building Application Form

Potlatch Fund is excited to announce the 2013 Community Building Granting Cycle to benefit Native organizations and peoples. Grants will be awarded in amounts ranging from $500 to $5,000. Potlatch Fund’s Mission aims to inspire and build upon the Native tradition of giving and to expand philanthropy within Tribal nations and Native American communities in the Northwest. The name, Potlatch Fund, reflects a Northwest coastal Tribal traditional ceremony and in the Chinook language potlatch means to give or a gift. Potlatches are a continued tradition where individuals share their good fortune through the distribution of gifts to members of their Tribe as well as those of neighboring Tribes. Whether residing on a rural reservation or within a large metropolitan area, nurturing a sense of community to essential to Native people. We support community projects or programs that impart values, histories, and knowledge across generations to make our communities stronger and healthier. We are particularly interested in supporting initiatives that address the root causes of social, economic, racial, or environmental injustice in Northwest Native communities. This year funding priority will be given to community projects or programs that provide leadership opportunities for Native youth. Who is eligible to apply?

The organization must be Native‐led nonprofit, Tribe, or a Department of a Tribe.

The organization must be located in the States of Washington, Oregon, Idaho or Montana.

The organization's mission must be aligned with the mission of Potlatch Fund.

The organizations that have previously received a Potlatch Fund grant, may only apply to this grant cycle if they have completed all past reporting obligations.


Applications from different departments, from within a Tribe, will be reviewed as separate organizations. Please note: We do not retroactively fund project work. How to apply


Email to:



Potlatch Fund Attn: Community Building 801 Second Ave, Suite 304 Seattle, Washington 98104

Applications must be received or postmarked by Friday, April 26, 2013.

For questions please contact the Office Manager at 206.624.6076 ext 10 or email [email protected].


Potlatch Fund Application FormSPRING GRANT: 2013 Community Building

Attachments (Please include ALL of the following items with your application)Applications may be submitted by:

eMailing the complete application to [email protected], or

printing and faxing the complete application to 206.264.7629, or

printing and mailing the complete application to: 801 2nd Ave, Suite 304 Seattle, WA 98104

Cover letter

Completed Application

Signed Certification Page

Previous year's organization and project financial statements (four pages maximum)

And if you (please check only one of the following):

Are a federally recognized American Indian Tribal Government or section 7871 organization:

A list of Tribal Council Members in the Grant Application

Are a 501(c) 3, or 50 (c) 4 attach:

Verification of your IRS approved tax‐exemption status

A list of Board Members and Staff in the Grant Application

Have a federally recognized Native American Tribal fiscal sponsor,

please state so in your cover letter and attach: please state so in your cover letter, and attach:



A list of their Tribal Council Members in the Grant Application

Have a 7871, 501 (c) 3, or 501 (c) 4 fiscal sponsor, state so in your cover letter and attach:

Verification of their IRS approved tax‐exemption status



A list of their Board Members and Staff in the Grant Application

Applications must be received or postmarked by Friday, April 26, 2013For questions please contact the Office Manager at 206.624.6076 ext 10 or email [email protected]


1) Organization Contact Information

Organization Name:

Website:

Address:

City: State: Zip:

Contact Name: Title:


Tribal Affiliation:

Phone: Fax:

Other Phone:






Fiscally Sponsored by a federally recognized Tribe, a 501(c)3, or a 501(c)4


Amount Requested: Total Organizational Budget:

Total Project Budget: Project Name (if applicable):

When and where does the project take place?


Which communities will be served? (Please check ALL that apply)



Regional Youth


Cultural Preservation Health Civic Participation

Education Social justice Economic Development

Environmental Protection Youth Empowerment

Which Tribe, or Tribes, will your work impact?

Potlatch Fund Application Form SPRING GRANT: 2013 Community Building


Please answer the following questions in the order listed below with 12 point font, single spaced. Click on the

top left corner of the translucent box to access the space provided.

‐ complete mission

‐ purpose

‐ when your organization was started

‐ history of accomplishments

1) Summarize this grant request (50 word maximum)

2) Organizational Background

Please include the following information:

3) How does your service (How will your project) positively impact the Native community you serve?

4) What will you do with the funds requested? And who will be served by your organization/ project?

***Describe the goals of your organization if you are applying for general support***

***Describe the project goals if you are applying for support of a specific project******Describe the project goals if you are applying for support of a specific project***

5) What would your organization do if only partial funding was available?

What aspect of the project would you fund first?

6) Why is your organization the best group to provide this service/ undertake this project?

7) List the people who are part of your organization or team.

***What are their responsibilities and Tribal affiliations?***

***Who will be responsible for completing the work related to this grant?***

8) What else do you want us to know about your organization?

If requesting funds for a specific project, please include answers to the following questions.

9) How will you know if your project has succeeded?

What will success look like?

10) When do you expect to accomplish the goals of your project?

Potlatch Fund Application Form SPRING GRANT: 2013 Community Building

5) Project Funding Proposed Budget Is income

Confirmed or

INCOME Provide details CASH Anticipated?

Government Grants** $ and Contracts $Tribal Support** $

$Foundation Support** $

$Corporate Support** $ $Individual Support** $

$Inkind Support** $


$** Support should include donations, grants, sponsorship, etc



Salaries and wages (break down by individual position and indicate full or part time): $ $E l 1 $ $Employee 1 $ $Employee 2 $ $Employee 3 $ $Consultant 1 $ $Consultant 2 $ $

$ $Supplies $ $

$ $$ $

Rental and utilities $ $Travel $ $Postage and delivery $ $Printing and Copying $ $Telephone and Fax $ $Inkind Expenses $ $Other Expenses $ $

$ $

Estimated Total Project CASH EXPENSES $ $

Current Year Operating Budget [annual totals]Year Ends on :



7) Please list all Tribal Council Members or Board Members and Staff

Tribal Council Members or Board Members

First Name Last Name Title Email Tribal Affiliations

1

2

3

4

5

6

7

8

99

10

11

12

13

14

15

16

17

18

19

Staff


1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Potlatch Fund Application Form

6) Fiscal Sponsor Contact Information (if applicable):

Applicant Organization Name:

Fiscal Agent Organization Name:

Mailing Address:

City:

State: Zip Code:

Phone:

Fax:

Website:

Fiscal Agent Contact Name:

Title:

Phone:

eMail Address:

Fiscal Agent Information Fiscal Agent Budget

Incorporation Date: Year Ending:

EIN #: Income $

SPRING GRANT: 2013 Community Building

State UBI #: Expenses $


Signature of Organizational Representative Title Date

Print Name of Organizational Representative Organization








(if applicable)


(if applicable)

Important Notes




Potlatch Fund will include information on this grant in its periodic public reports. Potlatch Fund may also refer to the grant in a press release, in which case a copy would be sent to you in advance. If you wish to make your own press announcement, please consult with Potlatch Fund.

Failure to comply with the terms of this grant application may result in immediate cessation of support from Potlatch Fund. In addition, if your organization expends or commits any part of the grant funds for purposes or activities other than the purposes and activities for which this grant is made, your organization must repay Potlatch Fund an amount equal to the amount of grant funds so expended for other purposes or activities.

Documents

POTLATCH FUND - NPAIHB › images › resources_docs › weeklymailout... · Potlatch Fund aims to inspire and build upon the Native tradition of giving and to expand philanthropy