The Libri Foundation
Books for Children Program
Grant Application Form

I. APPLICANT:

Name of Library:  

Street Address:    PO Box:  

City:    State:    Zip:  

Shipping Address (if different):  

City:    State:    Zip:  

Contact Person:    Title:  

Library Phone:     and/or Contact Phone:  

Library Fax:    E-mail:  

Previous BOOKS FOR CHILDREN grant recipient?  Yes   No  
If yes, what year?  

II. TYPE OF LIBRARY:

A. Please check the choice which BEST describes your library:
City, town, township, or village library
Branch of a city, town, township, or village library
      Name of main library?  
County library
Branch of a county library
      Name of main library?  
Combination town & public school library
Tribal library. Tribal affiliation?  
Other:
B. Does the library have any branches or bookmobiles? Yes   No
    If yes, how many?  

C. Is your library a member of a regional or cooperative system? Yes   No
    If yes,
1. What is the name of the system?
  
2. Are the libraries in the system governed jointly or separately?
  
3. How much funding does your library receive from the system?
  
4. What services does the system provide to your library?
  


III. AREA SERVED:

A. For what geographic area is your library the primary library?
Name of Area:  

Population of Area:  

Population of the town in which the library is located:  

In what county/parish/borough is the library located?  

B. What is the nearest city with a population of at least 40,000 people?
      

How many miles is the library from this city?  

C. Is there an institution of higher education in the library’s district? Yes   No  

    If yes, Name of the institution:  

D. What are the area’s primary industries? (Agriculture, fishing, forestry, mining, tourism, etc.)

      


IV. CIRCULATION/PROGRAMMING:

A. How many hours per week is your library open?  

Please list the library’s hours:   

B. How many hours per week are your branches open?   

C. Approximately how many patrons come into the library each week?  

D. Approximately how many of these patrons are children age 12 and under?  

E. What is the average number of books checked out each week?  

F. Approximately how many of these books are children’s books?  

G. What type and how many hours of children’s programming does the library offer? Programming can include storytelling, puppet shows, summer reading programs, service to day care centers, craft activities, etc. Please be as detailed as possible in the space allowed.
( You may enter up to 1280 characters. )

characters left



V. BUDGET INFORMATION: Please provide the following information for the applicant’s most recently completed fiscal year. If your library is a branch library and receives its funding from the parent institution: 1) answer the questions first with your library’s budget and 2) in parentheses, include the parent institution’s budget. Any funds listed in Part II, Section C, question 3 must be included as part of your total annual budget.

A. Total annual budget (ALL expenditures, inc. salaries):       

B. Total annual book budget (reference, adult, YA, children): 

C. How many paid employees does the library have?            

D. How many paid employees have an MLS, MLIS, or equivalent?  

E. How is the library funded?
( You may enter up to 500 characters. )

characters left


F. Has the library suffered any budget cuts in the last three years? Please explain.
( You may enter up to 500 characters. )

characters left



VI. LOCAL FUND RAISING: The library’s local sponsor(s) may raise between $50 and $350, which will be matched 2-to-1 by The Libri Foundation. The Foundation will only match funds raised by a local sponsor. It will not match funds taken from the existing library budget.

A. Who will be the library’s local sponsor(s)? Note: The local sponsor may be a formal group such as the Friends of the Library or a service organization, or it may be an informal group of library supporters.

B. How much money does the sponsor(s) plan to raise? (Must be between $50-$350)  
Important Note: The Foundation will not match more than $350.

C. How does the sponsor(s) plan to raise the matching funds? Please be as specific as possible in the space allowed.
( You may enter up to 640 characters. )

characters left



VII. NEEDS ASSESSMENT: Please explain why the library needs the Foundation’s assistance to acquire new children’s books.
( You may enter up to 640 characters. )

characters left


VIII. PUBLICIZING THE NEW BOOKS: Describe how the library plans to publicize and promote its new children’s books. Note: Libraries are strongly encouraged to celebrate their new books by hosting a special event, such as an open house or a special story hour.
( You may enter up to 640 characters. )

characters left


IX. BOOK SELECTION: Please list the book reviewing sources the staff consults when selecting children’s books.
( You may enter up to 640 characters. )

characters left


X. REPORT: All grant recipients are required to write a one-page report, in the form of a letter, within eight weeks of receiving the new books. The letter should include general information about the library and the community it serves as well as specific information relating to the BOOKS FOR CHILDREN grant on topics such as how the local funds were raised, how the books will be used, and the impact the new books had on the library (ex: new patrons, increased community awareness, increased circulation). Copies of newspaper articles and other publicity items about the grant should be attached to the report.

Do you agree to provide this report within eight weeks of receiving the new books?  Yes   No

The following information must be handwritten. Use your computer to fill in the answers to all of the questions above this line, then print this form, complete the handwritten information below and mail it to The Libri Foundation.



Signature of Authorizing Official:


Print Name:


Title:  

Date: 

Questions should be directed to:

Barbara J. McKillip, PresidentPhone: 541-747-9655
The Libri FoundationFax: 541-747-4348
PO Box 10246Email:
Eugene, OR 97440Web site: http://www.librifoundation.org
Hours: Mon.-Fri: 10-4 PACIFIC TIME

Completed application forms must be mailed to The Libri Foundation. Faxed or emailed applications will not be considered for a grant.

©2006 – This form may not be reproduced, duplicated, or used for any purpose other than to apply for a Libri Foundation grant.