Peeler/Casey Application

Peeler/Casey Funds

Online Grant Application
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Today's Date*

MonthDayYear
Project Title:*
Requested by:*
Name of person/group/congregation/agency requesting funds
Project Manager*

First NameLast Name
Mailing Address *

Mailing Address

Mailing Address Line 2

CityState

Zip Code
Website:*
Project Start Date:*

MonthDayYear
Date
Preferred Phone*
E-mail*
Name of person to contact regarding this grant:*

First NameLast Name
Business Phone
Preferred Phone*
E-mail*
Region Served:*
County, State, Country served
A representative of the Peeler/Casey committee will contact you in early May.

Organization
Describe either yourself, or your organization, or your congregation. (What is your mission statement? How does this project fit into your mission?)*

Limit 125 words.0/125

PROJECT DESCRIPTION
What is the purpose of the project?*
What areas of ministry will this project address and how was the need determined?*
What are the major goals of the project? (Description of target population. How many people do you expect to serve? What will the participants gain from your project?)*
Describe the effects of this project on the organization, clients, the congregation, or Synod.*
How does your project fit into the NC Synod mission statement of "God calls us to Cultivate and Celebrate Vital Congregations Identify, Equip, and Nurture Whole and Healthy Leaders Embrace and Engage in Collaboration Proclaim the Promise of the Resurrection with a Prophetic Voice All for the Sake of World"? (Please address only those that apply to your project.)*
Which of the synod core values does your project most align?(Jesus, generosity, relationship, and reconciliation) (Please address only those that apply to your project.) *

BUDGET/FUNDING
What is the total budget for this project? Delineating how the grant funds would be used*

Limit 100 word description.0/100
List all other funding sources for this project.*

0/100
If this is to be an ongoing project, how will it be funded in the future?*

0/100
If you receive only partial or no funding for this project, what will happen to this project?*

0/100
PERSONNEL
Describe staff/volunteer responsibilities for this project.*

Limit 250 words.0/250
EVALUATION
How will the project be monitored? What is your evaluation criterion and how will it be used to measure your success? *

0/250

(Please upload a copy of the minutes of the meeting at which this grant application was approved.)
Upload minutes...*

Word or PDF document.
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REQUIREMENTS

If a grant is approved, an end‐of‐year report must be submitted to the Synod office no later than Nov. 1 of the following year. Please be aware that this end of year report must be submitted before any further grants can be requested from the Michael Peeler/Virginia Casey Funds.

If you have received a grant in the previous year, please also fill out the End of Year Report found here or on our website and submit it with your application. Although your project may not be complete the report will be helpful as we consider your request.

Any unused funds should be promptly returned to the NC Synod Office and added back to the Peeler/Casey Funds. Any needed change in the project should be reported to the Peeler/Casey Committee by emailing Evin Burleson at EBurleson@nclutheran.org.
Upload any extra documents you need.

Any other reports or documents you need to submit.
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Peeler/Casey Funds