2135 Rimrock Road, P.O. Box 7843, Madison, WI 53707-7843 (608) 266-1311 | 1-800-WIS-VETS (947-8387) | WisVets.com
FY22 Nonprofit Grant Application Checklist Applications Due by 7/30/2021

Wis. Stats. Chapter 45 The following is a checklist of required information WDVA will be gathering in consideration of your application. All items on the checklist must be gathered, presented in packet form, and sent to WDVA once completed. Please return this completed checklist with your application. This is a required part of the application packet and shall be completed accurately, completely, and signed by the applicant.

Organization Name	Amount Requested
$

Required Application Information	Applicant Review	WDVA Employee Review
Grant Request Cover Letter	☐	☐
IRS Determination Letter	☐	☐
Financial Statements	☐	☐
Program/Project Proposed Budget (if applicable)	☐	☐
Annual Report/Literature for Programs	☐	☐
WDFI Certificate of Status	☐	☐
List of Board Members	☐	☐
Completed Application	☐	☐
Signed Terms & Conditions	☐	☐

Required Business Plan Information	Applicant Review	WDVA Employee Review
Organizational Experience Providing Services to Veterans	☐	☐
Understanding the Ability to Communicate the Needs of Veterans and their Dependents	☐	☐
Stated Purpose and Objectives for the Grant Funds, the Methods, and Timetable to Expend the Funds	☐	☐
Budget Clarity & Justification	☐	☐
Evaluation Plan for the Project	☐	☐
Program Goals & Objectives	☐	☐
Outreach & Referral Plan	☐	☐
Program Implementation Timeline	☐	☐
Past Performance	☐	☐
Experience Serving Underserved Populations or Underserved Geographic Areas	☐	☐
Past Working Relationships with Veteran Service Organizations	☐	☐

For descriptions or further instructions on the above, please refer to the grant application instruction sheet. Once this checklist and completed application packet is received by WDVA, a representative from WDVA will review your packet to ensure all required information has been received.

_________________________________________ _____________________________________________

WDVA Employee Reviewer - Print Name Applicant Print Name

X_ __________________________________ X_ ______________________________________

WDVA Employee Reviewer – Signature Applicant Signature