Minnesota Common Grant Application Form

Lewiston Altura Schools: Nurtrition Department

School Year: 2016/2017

Table of Contents:

Cover Letter…………………………………………………….3

Application Form……………………………………………….4

Grant Application Cover Sheet…………………………………5

Proposal Narrative……………………………………………...7

Organization Information…………………………………7

Purpose of Grant…………………………………………..8

Evaluation………………………………………………..10

Budget……………………………………………………12

Project Management Plan……………………………………..14

Logic Model…………………………………………………...15

Project Summary………………………………………………16

Appendix………………………………………………………17

Statement of Revenues & Expenditures…………………18

Lewiston Altura Schools ISD 857

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100 County Road 25Lewiston, MN 55952Phone: 507-523-2191Fax: 507-523-3460

April 20, 2016Name of FunderFunder TitleStreet AddressCity, State, Zip code

Dear (Name of Funder),Lewiston-Altura school district is in need of funding for new equipment in the kitchens and to increase the farm to school partnerships. The mission of the Lewiston Altura School District food service is educating to ensure health, happy customers. Vickie Speltz, the Food Service Director at Lewiston Altura writes grants and has partnered with area farms to bring in fresh healthy produce to the students and staff.

The goal of this grant is to help increase the amount of fresh produce they can provide for the three schools in the district. By making partnerships with the Rockie Hills Bison Farm, which provides buffalo burgers and bison sticks; Mueke Apple Orchard and Sekapp Orchard, the amount of fresh produce available to the students will increase. With the partnerships with local area farms, this allows the school to buy less canned vegetables/fruits and gives the students fresher, more nutritious produce. The Lewiston Altura School wants to purchase new ovens that can steam, roast, and bake. Instead of deep-frying, where the produce can lose it’s nutritional value. The ovens that can steam, roast, and bake cost about $12,000.00. These ovens may seem costly, but the benefits they could bring the school and the students are worth it.

Contact Vickie Speltz, the Food Service Director at the Lewiston Altura School District for responses. Vickie and the other food service cooks would enjoy if you came to the school and check out all the hard work and services they are providing these students at the Lewiston Altura School District.

Thank you for considering us for the grant request.

Sincerely,

Vickie SpeltzLewiston Altura Food Service Director

Minnesota Common Grant Application FormRevised December 2000

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Dear Nonprofit Colleague,

We are pleased to introduce an updated version of the Minnesota Common Grant Application form. Minnesota grantmakers developed this form to make the grantseeking process simpler and more efficient for nonprofits. For ease of use and to eliminate unnecessary duplication of work, you may reproduce any part of the form you find helpful including the COVER SHEET and BUDGET forms.

Keep in mind that every grantmaker has different guidelines and priorities, as well as different deadlines and timetables. Before submitting this application to a potential funder, it is very important that you check to see whether your project or program matches their published interests. Any funder that has agreed to accept this form may request additional information as needed.

STRATEGIES FOR SUCCESSFUL GRANTSEEKING

1. Do your research to determine whether the foundations’ and corporations’ goals and objectives for grantmaking are consistent with your type of grant request.

2. After you do the research, find out the preferred method of contact for the grantmaker, and contact the grantmaker to secure their specific grantmaking guidelines. Many grantmakers generally like to have initial contact with you before receiving a written proposal.

3. Include a cover letter with each proposal that introduces your organization and your proposal, and makes a strategic link between your proposal and the funder's mission and grantmaking interests.

4. Type and single-space all proposals.5. Answer all the questions in the order listed.6. Submit the number of copies each grantmaker requests according to their guidelines.7. Do not include any materials other than those specifically requested at this time.

RESOURCES

Call, write or check the website of each grantmaker to obtain a copy of their funding guidelines (for a list of MCF member grantmaker sites, visit MCF’s website at www.mcf.org/members).

Subscribe to Minnesota Grantmakers Online (MGO), Minnesota’s most comprehensive source for infomration on grants and grantmakers. www.mgomcf.org

Use directories listing foundations’ interests and processes. Visit a Foundation Center Collection Library (visit www.grantspace.org/Find-Us for

locations).To download the Form, visit MCF’s website at:

http://www.mcf.org/nonprofits/minnesota-common-grant-application-form

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Minnesota Common Grant Application FormGrant Application Cover Sheet

You may reproduce this form on your computer

Date of application: Application submitted to:

Organization Information

Lewiston Altura SchoolsName of organization Legal name, if different

100 County Road 25 Lewiston, MN 55952Address City, State, Zip Employer Identification Number (EIN)

507-523-2191 507-523-3460 http://www.lewalt.k12.mn.usPhone Fax Website

Jeff Apse Superintendent 507-522-3401 japse@lewalt.k12.mn.usName of top paid staff Title Phone E-mail

Vickie Speltz Food Service Director 507-522-3403 vspeltz@lewalt.k12.mn.usName of contact person regarding this application

Title Phone E-mail

Is your organization an IRS 501(c)(3) not-for-profit? Yes X NoIf no, is your organization a public agency/unit of government? X Yes No

If no, check with funder for details on using fiscal agents, and list name and address of fiscal agent:

Fiscal agent’s EIN number

Proposal Information

Please give a 2-3 sentence summary of request:Lewiston Altura School District has a team of dedicated faculty and administration including, Vickie Speltz, Food Service Director, they have come together to improve the nutrition and overall health of the children at school. The Nutrition Department would like to increase the amount of fresh fruit and vegetables for the students in order for them to increase their attention in the classroom, be active members of the community and beyond. The mission statement for the Lewiston Altura Nutrition Department is, “Educating to ensure healthy, happy customers.” Targeting students when they are young creates the opportunity for effective behavior change.

Population served: Approximately 700 students/day at each of the schools.

Geographic area served: Lewiston Altura, Minnesota

Funds are being requested for (check one) Note: Please be sure funder provides the type of support you are requesting.

General operating support Start-up costs Capital X Project/program support Technical assistance Other (list)

Project dates (if applicable): 2016/2017 school year

Fiscal year end: June 30, 2017

Budget

Dollar amount requested: $48,178.30Total annual organization budget: $ Unknown

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Minnesota Common Grant Application FormTotal project budget (for support other than general operating): $ Unknown

Authorization

Name and title of top paid staff or board chair: Jeff ApseSignature

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Minnesota Common Grant Application Form

PROPOSAL NARRATIVE

Please use the following outline as a guide to your proposal narrative. Most grantmakers prefer up to five pages, excluding attachments, but be sure to ask each individual funder if they have page limitations or any additional requirements. Also, include a cover letter with your application that introduces your organization and proposal and makes the link between your proposal and the mission of the grantmaker to whom you are applying. For assistance with terms, refer to MCF’s website (www.mcf.org; select “Nonprofits”, then “Grantseeking Resources”).

I. ORGANIZATION INFORMATION

A. Brief summary of organization history, including the date your organization was established.The Lewiston Altura School District was first consolidated in 1905, and it was the first consolidated school district west of the Mississippi River. The current population of the city of Lewiston and Altura is around 2,000. The school district also includes Altura. The district has 3 buildings with one building housing students in early childhood through 4th grade, an intermediate building, which is also the middle school, is 5th and 6th grade students, and the high school houses students from 7th through 12th grade. The total student population of the school district is 816.

B. Brief summary of organization mission and goals.Lewiston Altura School District’s vision is to provide for healthy and happy customers, which includes the teachers, parents, and students. Providing services to the growing number of students is the school’s main priority. Increasing the offerings of fresh fruit and vegetables to decrease obesity in the school district. Promoting healthy eating habits to the students in Lewiston Altura Schools. Providing healthy fruits and vegetables to the students and faculty. The mission statement of the school district is “Educating to ensure healthy, happy customers.”  

C. Brief description of organization’s current programs or activities, including any service statistics and strengths or accomplishments. Please highlight new or different activities, if any, for your organization.Some of Lewiston Altura’s programs that they are working towards, and have already accomplished is increasing partnerships between themselves and the local farms in the area. One of the farms is White Water Gardens and they supply apples to the school, when they are in season. There is also a co-op with a Rockie Hills bison farm in the local area. The students are able to receive bison burgers as well as bison sticks during their meal.

D. Your organization’s relationship with other organizations working with similar missions. What is your organization’s role relative to these organizations?The relationships that Lewiston Altura has with other organizations, shows how great the local community ties can be, and how it can improve the community as a whole. The role that Lewiston Altura plays, relative to the other organizations is that this is another outlet for the students to learn and understand where the food comes from. Instead of having the food shipped in from a “big company” vendor, the food is shipped in from local gardens and farms. More learning is done when the students take trips to the farms to learn from the farmers directly. The students see the full-circle effect that their food has, from the farmer, to the nutrition staff cooking the food, and then seeing the food on the their lunch trays. There are several partners the Nutrition Department works with; Rockie Hills Bison Farm located in Winona, MN. The department also partners with the state of

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Minnesota Common Grant Application Form

Minnesota Department of Defense for all locally grown items, Whitewater Gardens in Elba, MN, and Mueke Apple Orchard in St. Charles, MN.

E. Number of board members, full-time paid staff, part-time paid staff and volunteers.There are 7 people who are apart of the school board. These members are elected officials by the community and are paid to attend the meetings.

F. Additional organization information required by each individual funder.No information required at this time.

II. PURPOSE OF GRANT

General operating proposals: Complete Section A below and move to Part III - Evaluation.All other proposal types: Complete Section B below and move to Part III - Evaluation.

2. Activitiesa. Overall goal(s) regarding the situation described above.

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B. All Other Proposal Types1. Situation

a. The opportunity, challenges, issues or need and the community that your proposal addresses.b. How that focus was determined and who was involved in that decision-making process.

The Lewiston Altura School District was first consolidated in 1905. It was the first consolidated school district west of the Mississippi River. The current population of the city of Lewiston and Altura is 2,077. Lewiston Altura School District, Nutrition Department has seen an increase in their food costs over the last several years. According to the 2013 Minnesota Student Survey in Winona County, 8% of the 9th grade male population and 4% of the female population stated that they did not eat fruit in the last 7 days. In the same survey, 13% of the 9th

grade male population and 6% of the female population stated that they did not eat any vegetables in the last 7 days. There is an issue with access to healthy foods and the rising rates of obesity. According to the 2013 Minnesota Student Survey in Winona County, 8% of 9th graders are obese according to BMI, and, 22% of 9th graders feel that they are overweight. According to the 2013 Community Health Needs Assessment Report, 18% of people who filled out mail surveys in Winona County say that they worry about food running out or hunger and this increases to 38% in the immigrant population, which is mainly Hmong and Hispanic. This issue has also trickled into the schools and the districts, where some student’s only access to fresh fruit and vegetables is during the school day. It is important to have supplemental fruits and vegetables available during the school day in order for students to have enough energy for participation in classes, attention in classes, and overall health as children grow and develop into active members of the community. Research has shown that access to healthy food throughout the school day has the potential to positively impact student’s academic performance, as well as physical activity and positive eating habits. For all of these reasons, both the Lewiston School Board and Nutrition Director for Lewiston Altura Schools, Vickie Speltz, feel very strongly that there needs to be increased access to healthy, nutritious fresh foods throughout the school day.

A. General Operating Proposals1. The opportunity, challenges, issues or need currently facing your organization.2. Overall goal(s) of the organization for the funding period.3. Objectives or ways in which you will meet the goal(s).4. Activities and who will carry out these activities.5. Time frame in which this will take place.6. Long-term funding strategies.7. Additional information regarding general operating proposals required by each individual funder.

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Minnesota Common Grant Application Form

2. Activitiesa. Overall goal(s) regarding the situation described above.

Decrease obesity rates in the Lewiston Altura School District. Promote healthy eating habits to the students in Lewiston Altura Schools.

b. Objectives or ways in which you will meet the goal(s).Increase the number of farm to school partnerships by 100% by Fall of 2016 by working with Winona County GreenCorps.

Through building relationships with local farmers, by the end of the 2016/2017 school year, have a 10% increase in the amount of fresh fruit and vegetables available to the student’s of Lewiston Altura Schools due to an increase in farm to school partnerships.

The results in of the 2019 Minnesota Student Survey in Winona County will show a 3% decrease in the amount of students who are obese according to their BMI.

c. Specific activities for which you seek funding.Food Service staff will work with Winona County GreenCorps to develop a list of potential farm to school partners for the Lewiston-Altura Schools.

Implement Farm to School Day in August 2016 for the Lewiston Altura school district. Create a media event to increase awareness among parents and community members. Have this event be yearly occurrence.

d. Who will carry out those activities.Vickie Speltz, Food Service Director of Lewiston Altura Schools and the food service staff will implement these activities with the support of Lewiston Altura administration and staff. They will also partner with Winona County GreenCorps and other Winona County school districts to develop and implement activities related to farm to school.

e. Time frame in which this will take place.These activities are scheduled to begin with the start of the academic school year in 2016/2017.

f. How the proposed activities will benefit the community in which they will occur, being as clear as you can about the impact you expect to have.Increasing the access to healthy food and healthy behaviors in the Lewiston-Altura Schools has the potential to affect the lives of approximately 700 students in the school district. For some of these children, it may be their only access to healthy fruit and vegetables. Healthy behaviors need to be reinforced in young children so these behaviors can be continued into adult life. The healthy behaviors that will be reinforced will decrease obesity; because healthy fruit and vegetables will be offered while children are attending school. Through the continuation of these programs, an overall, healthier community will emerge in the future.

With the increase in the budget for fresh fruits and vegetables, and the Farm to School Day; if applicable, can continue being yearly programs that could potentially affect the health and wellness of younger generations of students and the community as a whole.

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Minnesota Common Grant Application Form

g. Long-term funding strategies (if applicable) for sustaining this effort.A long-term strategy that Lewiston Altura would like to achieve is to keep having the community be involved and to know that it is a vital part of the community and to the well-being of the students. A vital part of this would be to keep having the Farm to School Day every year. Another way that Lewiston Altura can have long-term success is with Vickie Speltz, the Food Service Director. In former grants she has had a lot of success with ones that she has applied for. For example, with one specific grant that she secured within the past year, the requirement was to have five farm to school programs secured within the first three years, she secured all five farm to school programs within the first year.

III. EVALUATION

A. Please describe your criteria for success. What do you want to happen as a result of your activities? You may find it helpful to describe both immediate and long-term effects.Increase the healthy options for students, so they can have healthy behaviors later on in life. The Lewiston Altura School District would also like to include the faculty because they are a vital part of showing healthy behaviors to the students. Students will have access to a variety of fresh fruit and vegetables. For the students of Lewiston-Altura Schools, have their BMI decrease by the 2019 Minnesota Student Survey.

B. How will you measure these changes?The Qualtrics survey will be developed to show what students think of the quality and variety of the produce, and this will deliver feedback to Vickie and the food service staff. Vickie will assess the 2013 and 2019 Minnesota Student Survey, to see if the BMI rate in school aged students decreased or increased.

C. Who will be involved in evaluating this work (staff, board, constituents, community, consultants)?Vickie Speltz, the Food Service Director and her staff will oversees the evaluation process by administering the Qualtrics survey to the students. This will be approved by the school board, and then consulted with community members of Lewiston Altura and parents/guardians of the students. The Vickie Speltz, along with administration and faculty of Lewiston Altura will be involved in evaluating the results from the 2013 and 2019 Minnesota Student Survey.

D. What will you do with your evaluation results?Try to improve on the health of the students of Lewiston Altura School District and compare these results with Winona County and the State of Minnesota. From the 2013 to the 2019 Minnesota Student Survey, we hope that with the results, that there will be an improvement between the years. Improving the community wellness and awareness in the Lewiston Altura area is important, and by doing this, a healthier community will soon emerge.

ATTACHMENTS

Generally the following attachments are required:

1. Finances (for assistance with terms, check MCF’s website at www.mcf.org/nonprofits/resources.) Most recent financial statement from most recently completed year, audited if available,

showing actual expenses. This information should include a balance sheet, a statement of

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Minnesota Common Grant Application Form

activities (or statement of income and expenses) and functional expenses. Some funders require your most recent Form 990 tax return.

Organization budget for current year, including income and expenses. Project Budget, including income and expenses (if not a general operating proposal). Additional funders. List names of corporations and foundations from which you are requesting

funds, with dollar amounts, indicating which sources are committed or pending.

2. List of board members and their affiliations. 3. Brief description of key staff, including qualifications relevant to the specific request.4. A copy of your current IRS determination letter (or your fiscal agent’s) indicating tax-exempt 501(c)

(3) status.5. If applying to a corporate funder only: if an employee of this corporation is involved with your

organization, list names and involvement.

Be sure to check each funder’s guidelines, and use discretion when sending additional attachments.

PROPOSAL CHECKLIST

Cover letter. Cover sheet. Proposal narrative. Organization budget. Project budget (if not general operating

grant). Financial statements, preferably audited,

showing actual expenses including: Balance sheet. Statement of activities (income and

expenses). Statement of functional expenses.

List of additional funders. List of board members and their

affiliations. Brief description of key staff. IRS determination letter. Confirmation letter of fiscal agent (if

required). Additional information required by each

individual funder.

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Minnesota Common Grant Application Form

ORGANIZATION BUDGET

This format is optional and can serve as a guide to budgeting. If you already prepare an organization budget that contains this information, please feel free to submit it in its original form. Feel free to attach a budget narrative explaining your numbers if necessary.

INCOME

Source AmountSupportGovernment grants $ -Foundations $ -Corporations $ -United Way or other federated campaigns $ -Individual contributions $ -Fundraising events and products $ -Membership income NoneIn-kind support NoneInvestment income None

RevenueGovernment contracts $ -Earned income $ -Other (specify) $ -

$-$ -$ -

Total Income $0

EXPENSESItem AmountSalaries and wages $ -Insurance, benefits and other related taxes $ -Consultants and professional fees $ -Travel $ -Equipment $ -Supplies $ -Printing and copying $ -Telephone and fax $ -Postage and delivery $ -Rent and utilities $ -In-kind expenses $ -Depreciation $ -Other (specify) $ -

$ -$ -

Total Expense $ -Difference (Income less Expense) $ -

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PROJECT BUDGET

This format is optional and can serve as a guide to budgeting. If you already prepare project budgets that contain this information, please feel free to submit them in their original forms. Feel free to attach a budget narrative explaining your numbers if necessary.

INCOMESource AmountSupportGovernment grants $ -Foundations $ -Corporations $ -United Way or other federated campaigns $ -Individual contributions $ -Fundraising events and products $ -Membership income $ -In-kind support $ -Investment income $ -

RevenueGovernment contracts $0Earned income $0Other (specify) $0

$0

Total Income $0

EXPENSESItem Amount %FT/PTSalaries and wages (breakdown by individual position and indicate full- or part-time.) $01st Trip: Bus Driver ($10.90/hour at 3.5 hours) $ 38.15 Unknown2nd Trip: Bus Driver ($10.90/hour at 3.5 hours) $ 38.15 Unknown

$ -$ -

SUBTOTAL $ 76.30Insurance, benefits and other related taxes $0Consultants and professional fees $0Travel ($1.70/gallon of diesel) (30 mile trip) X 2 trips

$ 102.00

Equipment $ 48,000 (oven that can steam, bake and roast)

Supplies $0Printing and copying $0Telephone and fax $0Postage and delivery $0Rent and utilities $0In-kind expenses No In-Kind expensesDepreciation $0Other (specify) $0

$0Total Expense $ 48,178.30Difference (Income less Expense) $ 0

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Project Management Plan

Key Personnel: Vickie Speltz, the Food Service Director, is the key personnel. Vickie has the right knowledge and expertise in order to handle the responsibilities. The people under Vickie, her food service staff will assist her in the project implementation. The credentials of these people will be attached at a later date (resumes and certificates (if needed)).  

Partner’s Contribution: During Farm to School Day, there will need to be volunteers in order to make the day run smoothly. The role for the volunteers will be to guide and help out participants as needed, help set up and take down the event, and direct crowds and traffic as needed. They will be supervised by Vickie Speltz on the day of the event and will be available to answer any questions. Screening, training, and monitoring of volunteers: The volunteers will be screened and trained by Vickie and her food service staff. Monitoring will be done the day of the events and Vickie and her staff will be available all day in order to answer any questions and direct people where they need to go.

Fiscal Management and Documentation: Vickie Speltz has had many experiences writing grants. Just the last year she obtained a grant to secure 5 partnerships with farms in the area, and she secured all 5 partnerships by the one year mark. Vicke also keeps documentation of all the shipments of food that come into all of the schools. Vickie will work with the school district's finance department to manage the funds within the organization, and she will also be authorized to expend the funds.

Evaluation: Evaluation of this project will include tracking the attendance rate for the Farm to School Day event. The evaluation of the curriculum cannot be determined after one year, this will take a few years in order to change parts of the curriculum that may not work. The chain of command will include the Superintendent and the School Board of Lewiston Altura, in order to keep Vickie Speltz accountable.

Project Documentation: Project documentation will take place by Vickie Speltz, Nutrition Director, the food service staff, and faculty. By their observations, they will be able to determine whether or not the programs and projects are going as planned.

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Logic Model

Situation Input Output OutcomesThe issue is that students aren’t getting enough fruits and vegetables in their diet.

Staff

Volunteers

Materials (Fresh Fruits and Vegetables)

Time

Money

Partners “Farm to School”

Train involved staff

Actively looking for Partners “Farm to School”

Conduct meetings for Farm to School Day

Advertise Farm to School

Administration and Staff would be decision makers in the activities conducted

Delivery services to bring the fresh produce

Working with the media about farm to school day to increase participation and awareness

Short: Students will learn the new skills related to healthy eating and a healthy lifestyle

Medium:Families will increase the amount of healthier options at home and decrease the amount of unhealthy behaviors of parents and teachers

Reinforce healthy behaviors in children in school “can be continued in adult life”

Long:Increase the access to fresh fruits and vegetables in the Lewiston Altura community

Proposal Summary12/2000 15

Lewiston Altura School District has a team of dedicated faculty and administration

including, Vickie Speltz, Food Service Director, they have come together to improve the

nutrition and overall health of the children at school.

The Lewiston Altura Schools and the Nutrition Department, would like to increase the

amount of fresh fruit and vegetables for the students in order for them to increase their attention

in the classroom, be active members of the community and beyond. The mission statement for

the Lewiston Altura Nutrition Department is, “Educating to ensure healthy, happy customers.”

Targeting students when they are young creates the opportunity for effective behavior change.

All of the schools in the Lewiston Altura School District will be included in this grant,

Elementary School, Middle School, and the High School. The project budget is estimated at

$48,178.30 and asking for that full amount. This would cover four ovens that will bake, steam

and roast, also this will include travel costs to and from the farms. Increasing access to healthy

food and reinforcing healthy behaviors has the potential to affect the lives of approximately 700

students in the school district. With accessibility of fresh fruit and vegetables, it is of the utmost

importance because these students are the future.

The Lewiston Altura Schools would like to thank you for doing business with the

proposal for increasing the allotment of funds for fruits and vegetables for the Nutrition

Department.

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Appendix

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