NCPlenty, Inc. 126 Justice Street Chapel Hill, NC 27516 www.ncplenty.org ncplenty@ncplenty.org

Mission Statement NCPlenty, Inc. is a non-profit corporation working to promote local commerce, fair wages, environmental responsibility, self-reliance, and neighborliness through the implementation and support of a local currency, the PLENTY.

Application for Grant Funds from NCPlenty, Inc.

· To be considered, all applicants must be nominated by a member of NCPlenty.

· Any grants awarded will be disbursed in PLENTYs. One PLENTY (1P) is equal to $10. There is a total grant allocation of approximately 70P for the annual period ending October 2005.

· Deadlines for submission are:

· 1^st round: June 30, 2005 – Grants to be distributed in July 2005

· 2^nd round: August 30, 2005 – Grants to be distributed in September 2005

Organization or Individual to Receive Grant

Name:

Contact Person:

E-mail: Phone number:

Address: Website:

_

_

Mission of this group/individual:

Does the organization have 501(c)(3) status? (Note: this is not required to receive a grant) ______

Nominating Member of NCPlenty (if different from above)

Name:

Relationship to the organization/individual seeking funds:

I nominate the aforementioned organization/individual for a grant from NCPlenty, Inc, believing this will promote the mission of NCPlenty as outlined above.

Signature of Nominating Member Date

[Application is continued on the reverse]

Grant Request

Please answer the following questions succinctly and thoroughly. Applicants may attach a letter of at most 3 pages in length, as well as copies of any relevant supplemental materials such as a mission statement, brochure, or annual budget.

1) Detail the planned use of funds (i.e. What amount is requested? What particular project or specific item(s) will these funds support? What percentage of the total project cost is represented by this grant request? When will the granted funds be spent? With whom will they be spent?). Funds need not be spent with members of NCPlenty to qualify, but we prefer the use of members where possible.

2) Describe in detail how the planned use of funds promotes NCPlenty’s mission, including the support of one or more of the following: local commerce, fair wages, environmental responsibility, self-reliance, and neighborliness.

I attest that, to the best of my knowledge, the answers to the above questions are accurate and complete. I understand that I am not guaranteed any funds, nor that a grant will necessarily equal the requested amount. Any received funds must be used for the purposes stated on this application.

Signature of Prospective Grantee Date