Congratulations on your Make A Difference Grant award! We are so excited to work with you. Please complete all the sections below in order to officially accept your MAD Grant. Please enable JavaScript in your browser to complete this form. - Step 1 of 4Grant Recipient/Organization: *The MAD grant shall be used for the purposes described in the grant application and project description. The acceptance letter from Youth Resources gives specific instructions on the breakdown of funds for intended project. *CONFIRMYou will be responsible for all original receipts, bills, and invoices that are disbursed by you. Youth Resources will not reimburse state sales tax because you are a tax exempt non-profit organization. Your organization can provide you with a tax exempt form to use when making purchases for your project. Following the end of your project, your final report that you will be sending to Youth Resources, will need to have any original receipts (or copies of the receipts) attached to your final report. Grant recipients will be reimbursed for their project costs after ALL final reports, pre/post/final surveys and receipts have been turned in to Youth Resources. *CONFIRMUnder no circumstances may MAD grant funds be expended, borrowed, (inter-fund), pledged, or transferred for reasons not associated with the stated purposes contained in the grant application. No fees will be paid to hired help or to other organizations. Capital items cannot be purchased with grant funds (e.g. digital cameras, video cameras & equipment, electronics, pots, pans, electric mixers, etc). *CONFIRMUnused portion of the grant money will be returned to Youth Resources. Funds used for unapproved and/or unbudgeted items must be returned to Youth Resources. *CONFIRMYour project will take place during the time specified in the grant proposal unless a written extension is approved by Youth Resources. Final reports are to be submitted to Youth Resources two weeks after students have completed the project. If an event occurs where your project completion dates need to be extended, Youth Resources will need a minimum 1 week of notification for these changes to take place. *CONFIRMA narrative project evaluation is due two weeks after the project is completed. The report should include the following: Written evaluations from youth on the project process and end results (The process will be made easier by using the pre and post evaluation forms included with this packet.). Please include photos throughout and at the completion of your project that show your project in action. Please submit final evaluations to Youth Resources no later than two weeks after the project is completed. *CONFIRMYouth Resources will be given a timetable of project activities so that site visits can be made during the course of the project. Any changes on the Start-Up Form must be reported to Youth Resources MAD Program Manager at least one week before any project changes are made. *CONFIRMYou will abide by the revisions made by the grant screening committee as specified in your grant acceptance letter. Keep in mind that youth recognition should not exceed 5% of total grant. *CONFIRMYou are not to discriminate on the basis of any race, disability, religion, or national origin. Youth Resources Nondiscrimination Policy: Youth Resources of Southwestern Indiana, Inc., hereinafter referred to as "Youth Resources" hereby adopts and adheres to the following policy of nondiscrimination. No person shall, on the basis of race, creed, color, national origin, gender, or sexual orientation, be excluded from participation in, be denied the benefits of, or otherwise subjected to discrimination, by Youth Resources. *CONFIRMYouth Resources will be mentioned in all promotional materials: brochures, t-shirts, bags, plaques, press releases, publicity, etc. Our logo will appear on all printed materials and t-shirts connected with publicizing your project. Youth Resources will provide you with an electric copy of our YR logo when needed. *CONFIRMIf there are any changes that need to be made to your project, the MAD screening committee will need a minimum of one week’s notification in order for any of your changes to be approved. Please call or e-mail the Youth Resources MAD Grants Program Manager to start this process. *CONFIRMYouth Resources will be notified of any changes in project advisors and/or change of address. *CONFIRMMake A Difference projects must be completed and all paperwork submitted by Friday, May 14, 2021. *CONFIRMBy accepting these grant funds from Youth Resources I agree to the above terms and conditions set forth by Youth Resources. I understand that failure to comply with the terms of this agreement can result in our school/organization returning all awarded grant funds and may disqualify our school/organization from future funding from Youth Resources.Adult advisor signature: *FirstLastAdult advisor title: *Applying agency leadership signature (principal/Executive Director or other): *FirstLastApplying agency leadership title: *NextGrant Start-Up FormGrant recipient/organization: *Adult advisor: *Amount of grant funding approved: *Date project preparations will begin: *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920When your project will take place: *Please include date(s), time(s), and location(s).PreviousNextLiability & Photo Release UploadA Photo & Liability Release needs to be filed for all participants. Please merge all liability & photo releases into one PDF to avoid exceeding the maximum upload size. We like www.ilovepdf.com for merging and compressing PDFs.File Upload * Click or drag a file to this area to upload. PreviousNextPre-Survey UploadA Pre-Survey needs to be filed for all participants. Please merge all pre-surveys into one PDF to avoid exceeding the maximum upload size. We like www.ilovepdf.com for merging and compressing PDFs.File Upload * Click or drag a file to this area to upload. Submit