Pioneer Seed Grant Application
To stimulate local 4-H clubs in Iowa to plan and carry out community improvement activities, the Iowa 4-H Foundation in partnership with Pioneer, provides “seed money” needed to make the projects successful. Applications are due to be reviewed by county staff, approved, and sent to the state office by January 30 via this form.
Name of 4-H Club
*
County
*
Please Select
Adair
Adams
Allamakee
Appanoose
Audubon
Benton
Black Hawk
Boone
Bremer
Buchanan
Buena Vista
Butler
Calhoun
Carroll
Cass
Cedar
Cerro Gordo
Cherokee
Chickasaw
Clarke
Clay
Clayton
Clinton
Crawford
Dallas
Davis
Decatur
Delaware
Des Moines
Dickinson
Dubuque
Emmet
Fayette
Floyd
Franklin
Fremont
Greene
Grundy
Guthrie
Hamilton
Hancock
Hardin
Harrison
Henry
Howard
Humboldt
Ida
Iowa
Jackson
Jasper
Jefferson
Johnson
Jones
Keokuk
Kossuth
Lee
Linn
Louisa
Lucas
Lyon
Madison
Mahaska
Marion
Marshall
Mills
Mitchell
Monona
Monroe
Montgomery
Muscatine
O’Brien
Osceola
Page
Palo Alto
Plymouth
Pocahontas
Polk
East Pottawattamie
West Pottawattamie
Poweshiek
Ringgold
Sac
Scott
Shelby
Sioux
Story
Tama
Taylor
Union
Van Buren
Wapello
Warren
Washington
Wayne
Webster
Winnebago
Winneshiek
Woodbury
Worth
Wright
Number of 4-H Members in Club
*
Project Chairperson (4-H'er)
*
First Name
Last Name
Project Chairperson Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Project Chairperson Email
*
example@example.com
Project Chairperson Phone Number
*
Please enter a valid phone number.
County Youth/4-H Coordinator Name
*
First Name
Last Name
County Youth/4-H Coordinator Email
*
example@example.com
Adult Leader
*
First Name
Last Name
Adult Leader Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Adult Leader Email
*
example@example.com
Adult Leader Phone Number
*
Please enter a valid phone number.
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Grant Project Name
*
Total Project Budget
*
Must be between $50-$500.
Amount Requested from Foundation Grant
*
Must be between $50-$500.
Statement of Need
*
Describe the problem/issue in your community you wish to address
Proposed Project
*
Describe your project in one or two sentences. Tell how your project will address the identified need. Who or how many will benefit from this project?
Goals for Your Club
*
What knowledge, attitudes, and skills does your 4-H group expect to learn through the different stages of this project?
Methods
*
Describe what you plan to do to meet the needs and accomplish your goals. Include a timetable for the project.
Involvement in the Project
*
What part will the 4-H members play in planning and carrying out the project? Describe assignments and responsibilities to include all members. What will other individuals, service organizations and agencies do on this project?
Evaluation Plan
*
How will you measure the outcomes of your project? How will you determine if you have met your goals? What is your plan for sharing your accomplishments?
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Project Budget
Give expected income and expenses for this project for one year. Expense line must equal income line. The amount requested should equal no more than half the budget, not to exceed $500.
Estimated Project Expenses
*
Expense Item
Amount
Notes
1
2
3
4
5
6
7
8
9
10
Total Expenses:
*
Estimated Project Income (Funding)
*
Funding Source
Amount
Notes
1
2
3
4
5
6
7
8
9
10
Total Income:
*
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Upload Letter(s) of support here:
*
Browse Files
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A letter of support from the governing board of the project location MUST accompany the application.
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Signature of Project Chairperson (4-H'er)
*
Submit
Should be Empty: