P.I.C.K. Grant Application

Granges applying to PICK must include the following information in order for a project to be considered for partial funding.

Name of Grange_________________________________________________________

Contact Person_________________________________________________________

Complete address_________________________________________________________

Telephone_________________________________________________________

E-mail if available_________________________________________________________

WHICH CATEGORY ARE YOU FOCUSING ON?  PLEASE CHECK ONE.

____Women                            ____Youth                              ____Juniors    

____Community Improvement                                  

Name of project or activity: _______________________________________

Date of potential project or activity:_________________________________

Where will this project of activity take place?_________________________

_____________________________________________________________

Description of project or activity, include the purpose of the project or activity.  (What do you hope to will be the outcome of the project or activity?)

List as many details as possible about the proposed activity or project.  (For example if you are planning to offer workshops give the titles of workshops, a description of the workshop and who will be conducting the workshop.)

Total financing needed for the project or activity (Please include the amount you think your Grange and community will provide for the project and the amount you would like PICK to provide.)

When the project or activity is completed how will you evaluate it?

At the conclusion of the project if funding is granted from PICK the Grange must provide PICK with a report on the project or activity and photographs as well as copies of all receipts for the projects funding.