Monongalia County Commission

Edward A. Hawkins, President Tom Bloom, Commissioner Sean P. Sikora, Commissioner

243 High Street, Room 202 Morgantown, West Virginia 26505 304-291-7257

TO: Agencies and Organizations Requesting Funding
FROM: Rennetta McClure, County Administrator
SUBJECT: Funding Application availability
DATE: January 24, 2020

The Monongalia County Commission is pleased to announce that the 2020-2021 County Grant Funding application is now available. The application is accessible by visiting:

You will need to submit an application by using the Online Submission Form and upload the required documents directly to the website. Once all required documentation is received, our office will send you a confirmation email. If you are unable to access the Online Submission Form, you will need to contact our office and request a paper application.

The following information is REQUIRED to be eligible for funding consideration:
- Funding application
- Certification of compliance regarding lobbying activities
- Resolution to be passed by your agency board members
- Narrative of Financial Status

PLEASE NOTE: Sufficient documentation/detail needs to be provided to allow the Commission to determine the financial status of your organization (Examples of relevant documents include but are not limited to the following: Statement of Income and Expenditures, Balance Sheet, Recent Audit Report OR Financial Statement)
- List of officers, board members and their titles and contact information

Please keep the following items in mind:
- All forms must be submitted on or before 4:00 p.m. Friday, February 21, 2020.
- Grant funds should be restricted for a specific project – not for general operating purposes. 
- Funding decisions are made based on the quality and completeness of your application. Previous grant awards to your organization are not a guarantee of future funding.

If you have any questions, please contact the County Commission Office at info@moncommission.com or 304-291-7257.

Monongalia County Commission Grant Funding Application Fiscal Year 2020-2021

 Name of Organization Requesting Grant Funding:
Name of Organization
Address:
Address
Address Line 2:
Address Line 2
City:
City
State or Province:
State or Province
Zip or Postal Code:
Zip or Postal Code

 Organization Phone Number:
Phone Number

Organization Email Address:
Organization Email

CEO/President/Executive Director:
CEO/President/Executive Director Name

Financial Contact
Financial Contact Person

Financial Contact Phone Number:
Phone Number

Financial Contact Email:
Financial Contact Email

Name, Address, Phone Number and Email of person completing this Application:

Name:
Name
Address:
Address
Address Line 2:
Address Line 2
City:
City
State or Province:
State or Province
Zip or Postal Code:
Zip or Postal Code
Phone Number:
Phone
Email Address:
Email Address

 Amount of grant funding requested:
Requested Amount

 Name of Project:
Name of Project

 Please provide a brief profile of the organization:
Brief Profile of Organization
 State the reason for the request highlighting the project and the benefits to the citizens of Monongalia County:
State Reason

How many individuals are expected to benefit from the project?
Amount

If other organizations are collaborating on the project, provide the name(s) of organization(s) and a brief description of the collaboration. *If No Collaboration, Please Type "None".
Collaborating Organizations

Do you envision this project as a continuing, long term project with future financial needs?
Yes No
If yes, how do you plan to fund in the future?
How do you plan to fund in the future?

How many volunteers will contribute time to the project?
Amount

 Anticipated date of project completion:
Anticipated Comp Date

Anticipated budget of project (include funds received or requested from other sources)
Construction - Construction
Materials/Supplies - Material/Supplies
Other - Other Other Detail
Total Cost - Total Cost

 Have you requested and/or received funding from another organizaton or foundation for the project?
Yes No
If Yes, Please List:
If No, type None in Box
Other Sources

 Does your Organization have an annual audit?
Yes No
If yes, Please upload here:

Is your organization designated by the IRS as a NON-PROFIT?
Yes No
If Yes, what date did you receive IRS approval? (MM/DD/YYYY) and Upload IRS Determination Letter
If No, type None in box
Approval Date
IRS Determination Letter: 
What are the expected outcomes from the project and how will they be measured?
Outcome #1

What is the target population for the project?
Amount

What geographic area will this project serve?
Geographic Area

 Date Submitted: (MM/DD/YYYY)
Date

Additional Documents and Comments

File Upload for Additional Documents, Please refer to the Cover Letter for Additional Documents needed for Grant Submission.

Individual Documents:
Statement of Income and Expenditures (.pdf)
Balance Sheet (Narrative of Financial Status)(.pdf)

NOTE! To clear a selected file: Click the Choose File(s) button and Click Cancel

 
Questions and Comments:
Questions and Comments

Resolution

The officers of the Name of Organization met on Date(MM/DD/YYYY) with a quorum present and passed the following resolution:

BE IT RESOLVED thatName of Organization is requesting grant funding from Monongalia County Commission in the amount of $ Funding Amount to be used for Purpose

We, the Name of Organization, are submitting a completed application and agree to comply with all requirements as set forth by the Monongalia County Commission.

President or Authorized Representative  - Electronic Signature

Date - Date (MM/DD/YYYY)