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1. Organization Name:

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2. Contact Name:

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3. Contact Email:

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4. Organization's Address:

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5. City:

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6. State:

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7. Zip Code:

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8. Phone Number:

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9. Please provide a brief summary of your organization mission and goals:

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10. Title of Funding Request:

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11. Program Start Date:

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12. Program End Date:

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13. Provide a brief summary of the program.

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14. Which strategic area of the Minnesota Foundation for Agriculture does your request support? (refer to MFA website for more information)

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15. How does this program address the strategic areas of Community Vitality, Engagement or Research?

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16. How does the program strengthen the Mission of the Minnesota Foundation for Agriculture?
Mission: The Minnesota Foundation for Agriculture honors the roots and fosters the future of agriculture by supporting engagement, research and community vitality efforts.

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17. Please list 2-3 measurable goals for your program:

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18. What makes your program unique?

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19. Targeted age group?

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20. Geographic area served:

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21. Total Program Budget: (copy & paste)

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22. If there are funding levels, please decribe them below:

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23. Is this program and event or a program?

T