Grant Application Form

Your Organization Information

Organization Name*

Tax ID/EIN*

Founding Year*

Phone*

Website

Mailing Address*

Street Address City State / Province / Region ZIP Code Country

President/Director Name*

First Last

Contact Information*

Business Email Address

Project Leader Name*

First Last

Contact Information*

Business Email Address

Organization's Mission or Vision Statement*

Proposal

This section describes the collection and its value.

Describe the significance and strengths of the record set:*

Demonstrate the connection between the records and relevant areas of historical/genealogical research:*

Describe the anticipated impact of the completed project on the local community and/or Kentucky researchers:*

Describe availability and how researchers will access the records, once digitized:*

Has your organization completed similar projects in the past?*

Yes

If so, please provide a brief description of the project and any relevant lessons learned:*

What are the measurable goals this project hopes to achieve?*

Record Set Information

Approximate age of records in years:*

Describe the medium (e.g. bound ledgers, photographs, etc.) and the general condition of the record set:*

Chronological and Geographic Information

Describe the timeframe and any historical significance related to the time the record set was created:*

Describe the geographic region associated with the records:*

Describe the type(s) of material(s) in the record set:*

Check all that apply

Ephemera

Land Records

Maps

Obituaries

Photos of Known/Identified Individuals

Photos of Known Locations

Photos of Unknown (Unidentified) Individuals

Photos of Unknown Locations

School Records

Scrapbooks

Vertical/Subject Files

Author/creator of records, if known:

Approx. total pages or items:*

Any other information you would like to provide regarding the contents of the record set:

Current Availability and Holdings

Where is the record set currently stored?*

Describe the condition of the records with regard to where it is currently stored:*

For example, printed on fragile paper, no safe storage options available, ink fading, etc.

Has any portion of this record set been digitized previously?*

Yes

If so, please describe:*

Current availability*

Check all that apply

Available online

Available online; restricted access to digital copy

Available for in-person in public location

In-person review in private location

No current access

Other known holdings (describe below)

Description of Other Known Holdings*

Complete this field if you checked "Other known holdings" above.

Financial Needs and Steps for Implementation

Amount requested for the project:*

Provide a general description of the intended use for the funds*

Include a narrative and a line item breakdown of the intended use for the funds. For example: purchase of certain equipment, use as wages for individuals working on the project, etc.
Note: This information may be attached as a separate document if needed.

Upload Description of Intended Use

This step is optional and provided for convenience.

Accepted file types: pdf, Max. file size: 5 MB.

If the project budget exceeds our grant funding, discuss any plans for securing additional funds.*

Authorization

Describe your organization’s plan for providing both progress reports and expense reports for the duration of the project.*

Organization Agrees/Acknowledges:*

Grant seeking organizations agree that the funds will be used to complete their project within one year of receipt, provide the grant committee with quarterly reports on project progress, and provide KYGS with a copy of all files or objects digitized. Grantees also acknowledge that KYGS will use project images, descriptions, and organization partnerships in promotional material in a variety of media outlets.

Yes

IRS Letter of Determination (PDF Format)*

Submit as PDF

Accepted file types: pdf, Max. file size: 5 MB.

Signature*

Completion of the grant application requires the agreement of an individual with the authority to endorse the project outlined in this document. By checking the box below and typing your name, you agree to the terms and conditions.

I agree to the terms and conditions.

Name*

First Last

Title*

Today's Date*

DD dash MM dash YYYY

Digitization Grant Program

Overview

Your Organization Information

Proposal

Record Set Information

Chronological and Geographic Information

Contents

Current Availability and Holdings

Financial Needs and Steps for Implementation

Authorization

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