First 5 Lake Mini Grant Application
Fiscal Year 2025-2026
Please review the Request for Proposal and the Grants criteria before filling out this application.
Name of Agency/Organization
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Primary Contact
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First Name
Last Name
Title
Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Secondary Contact
First Name
Last Name
Title
Phone Number
Please enter a valid phone number.
Email
example@example.com
Agency Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Fiscal Agency (if different from applying agency)
Type of Agency (select one)
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County or City Government Agency
County or State Educational Institution
Non-Profit/Community Based Organization
School District
Tribal
Private Entity/Institution
Other
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Program Narrative
Name of Proposed Program/Service
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Project Start Date
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Month
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Day
Year
Date
Project End Date
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Month
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Day
Year
Date
Total Amount Requested
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Grants will be awarded for a minimum of $5,000 and a maximum of $100,000 per year for a period of 3-years
Please provide a 2-3 sentence summary of your project and its purpose. Identify at least one result that you expect to achieve.
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Proposed programs or services must address at least one (1) goal (check all that apply)
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Families have access to perinatal supports
Families have access to and knowledge of Early Care and Education Programming
Children have access to Oral Health services and education
Children's basic needs are met
Children live in safe and stable environments
The Early Care and Education field offers high quality educational instruction and environments for young children
Families have access to and knowledge of Early Care and Education Programming
Children receive early screening and intervention for developmental delays and other special needs
Families and those that serve them understand child development
Families have access to community supports and resources
Families read to their children on a regular basis
Describe your funding request in detail. Describe the strategies or practices that will be utilized to fulfill the First 5 Lake Strategic Plan goal(s).
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Describe how your proposed strategy/project is evidence-based, evidence-informed, promising practice, or a new innovation.
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Describe specifically who your project will serve (target population).
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Describe how your request will benefit pregnant women, children ages 0-5, their families, or providers working with children 0-5.
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Individuals estimated to be served:
Children 0-2
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Children 3-5
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Parents/Guardians of Children 0-5
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Providers
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Describe your organization's capacity to implement the proposed project. Please identify how you will bring the project to fruition in the event of staff changes.
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Describe exisiting partnerships that would directly or indirectly strengthen the proposed effort.
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Describe what you will accomplish and how you will know if you have been successful. Discuss the monitoring and control function(s) that will be used to ensure model fidelity and program integrity as related to day-to-day activities. Identify the staff assigned to these responsibilities.
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Budget Narrative
Please provide a thorough narrative explanation for your proposed budget.
A. Personnel
List positions, FTE % on project, rates, etc.
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Total Salaries
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Benefits
List all benefits and % covered by this grant
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Personnel Expenses Subtotal
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B. Program Expense
Itemize Direct Service Costs, Mileage, Staff Trainings, Professional Services, and Other Expenses
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Program Expenses Subtotal
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C. Administrative Expense
Itemize Rent, IT, Phone, Equipment, Office Supplies, and Other Expenses
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Administrative Expenses Subtotal
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D. Direct Expenses Subtotal (A + B + C)
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E. In-Kind: Describe any in-kind funding that will support this proposal
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F. Indirect Costs (max 15% of direct)
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Total Budget
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Describe the fiscal management experience of the fiscal agency and discuss the fiscal controls that will be used for this project.
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Provide a brief description of the fiscal agency's accounting system.
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If a collaborative proposal, describe how all partner(s) expenditures will be monitored and verified.
Describe your agency's experience in sustaining grant-funded programs for children and families.
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Upload Budget Spreadsheet
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Name of Authorized Signer
First Name
Last Name
Authorize Signature
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