Grant Acceptance Form

The Bartlesville Community Foundation is delighted to present you with a grant! Please review the following information and complete the form by the date provided to you in your notification letter to accept your grant.

By completing this form, you/your organization agrees to the following conditions.

I/We agree that the funds received will be used solely for the purposes outlined in the grant proposal. Foundation funds will not be used for any other project or expense without the expressed consent of the Foundation.
I/We agree to expend the grant funds within one year of receipt and provide a grant report as outlined below upon completion or one year from the date of this acceptance.
I/We agree to acknowledge the Bartlesville Community Foundation in all publicity and materials related to the program. If a Foundation logo or quote is required I/We should contact the BCF to request such material. Please contact us at 918.337.2287, by e-mail, or through this contact form.

Reporting Requirements:

On the one year anniversary or within 30 days of our projects completion, whichever is sooner, we will provide the Foundation with a written grant report. The report shall include:
- Information on the completion/success of the project
- Specific information on how the Foundation’s grant funds were utilized
- Photographs (if possible) of the project that the Foundation may use for publicity purposes

Recipients who have not yet submitted a report by the deadline are required to return any unexpended funds, or make a written request for an extension of the grant. Failure to report in a timely fashion will be a consideration when applying for future grants from the Foundation.

Organization Name(Required)

Project/Program Name on Application(Required)

Name of Grant Being Accepted(Required)

Allied Arts and Humanities Fund

Fund for Bartlesville

Geraldine Hicks Fund

Legacy Hall of Fame Fund

Rich and Kathleen Rutledge Fund

Service League Fund

Schmoldt Family Foundation for Education Fund

Washington County Healthy Living Fund

Other

Grant award amount being accepted by your organization:(Required)

Please enter a number greater than or equal to 0.

Date you expect to submit a Grant Report Form:(Required)

Due when the project is complete or one year after award is accepted, whichever comes first.

I, the undersigned, agree to fulfill this agreement as outlined.(Required)

Please type your name

Your title/relationship with the organization:(Required)

Your phone number:(Required)

Your e-mail address:(Required)

Name

This field is for validation purposes and should be left unchanged.