Western Iowa Journalism FoundationGrant Application Name of news source: * Organization address: * Address 1 Address 2 City State/Province Zip/Postal Code Country Organization contact name: * Contact email: * Contact cell phone: * (###) ### #### Are you a news source located in western Iowa (west of Interstate 35)? * If the answer is no, we are sorry to inform you that you do not meet the criteria to request a grant from Western Iowa Journalism Foundation. Yes No Are you a nonprofit or for-profit news source? * Nonprofit (provide a copy of federal nonprofit status ruling) For-profit Please provide your relevant tax ID number: * How do you fit the criteria of being a community-based news source? * Briefly describe the history and ownership of your news source. * How many reporters (full-time and part-time) do you currently employ? * How many people do you employ in other roles? * How do you quantify the size and reach of your audience (i.e., circulation, viewers, etc.) * Grant amount requested: * What is your organization’s overall operating budget? * What is the total budget for this specific project? Which WIJF objectives will be addressed by your request and project? * (Check all that apply.) Promote and protect democracy by serving as a watchdog on local government and institutions. Enhance operational/financial efficiency of community news sources. Support audience growth through technology integration. Improve community identity and civic engagement. Assist with succession planning to preserve local news sources. Encourage local news startups in existing news deserts. Elevate underrepresented and diverse voices in the interest of equity and belonging throughout the community. Combat mis/disinformation with verified local news Describe in detail how the grant funds will be used. * How do you intend to measure the impact of your proposed project? * Please disclose any potential conflicts of interest between your organization and Western Iowa Journalism Foundation, including its Directors, Officers, agents, advisors, consultants, contractors, employees, and volunteers. * I attest and declare that the information given on this application is true, correct, and complete. * True False Name * First Name Last Name Date * MM DD YYYY Thank you!
