4-H Service, Innovative Education, and Philanthropy Grants Application Form

Youth Applicant First Name

Youth Applicant Last Name

4-H Club or Group

Email Address

Street Address

City

State

Zip Code

Phone

Youth Members

(Names of Team Members)

Adult Partner/Mentor First Name

Adult Partner/Mentor Last Name

Adult Partner/Mentor's Email

Adult Partner/Mentor Street Address

Adult Partner/Mentor City

Adult Partner/Mentor State

Adult Partner/Mentor Zip Code

Adult Partner/Mentor Phone

Grant Application

Name of Project

Mission/Vision

Project Description

Plan of Action

Who's benefiting from the project?

Why should the 4-H Youth Trustees support your project?

Budget

See example (opens in a separate tab)

Income

(Please indicate if funding is pending)

Match

(Do you have any other support for the project?)

Expenses

Supplies/Materials

Travel

Food Costs

Printing

Advertising

Equipment

Other

Total Expenses

Total Request

Following Grant Approval

Your club or team will be expected to submit photos and impact information. The Youth Trustees will anticipate seeing a written description of the project success, and data that applies to the project and photos (with releases).

Please Note: The Youth Trustees in Philanthropy will not support individuals, illegal activities or any other costs not in compliance with 4-H Youth Development program, Maine 4-H Foundation or University of Maine policies. The Youth Trustees may at times limit funding to areas financially supported by the donor request until such time that the Youth Trustees have developed a general fund.

Questions: Please Contact Susan Jennings at 615-7300 and one of the Youth Trustees will get in touch with your youth leadership representative.

Our club agrees to the conditions of the grant proposal and agrees that if for any reason the club/team cannot complete the project, will return all unspent funds.*

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