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What activities are you planning to help you reach this target? How will you evaluate your activities? C B R 2 2.

Educate-Motivate: As a result of this grant project, how many people in-total will you personally one-on-one engage - helping them learn and respond to charitable gifting tool options? A B C How will you evaluate your activities? Generate: Of the total number of people you plan to personally one-on-one engage in considering charitable gifting tool options, how many individual donors do you expect to involve in actual donating immediate or deferred gifts? As a result of this grant project, what is your total gifting goal?

What is an EIN? - Employer Identification Number

What activities are you planning to help you reach these targets? Activities Target Dates Start date 1. End date final report will be requested in early Sustainability: If your project will extend beyond the life of the grant, please explain how it will be resourced Acknowledgement: How will you acknowledge the financial support grant from the Thnvent Financial for Lutherans Foundation to your constituencies?

Include in-kind contributions. O Churches or church organizations for expenses normally regarded as church responsibility O Duplicate services provided by other agencies O Religious causes O Political causes ft Endowments Employee Giving Campaign Matching Grants The Thnvent Financial for Lutherans Foundation matches Thnvent Financial for Lutherans employee donations pledged to the United Way and the Lutheran Community Foundation dunng the annual employee giving campaign Employee Gift-Matching The Employee Gift-Matching Program encourages personal philanthropy by matching, dollar for dollar, contnbutions of employees, field members, retirees and board members to nonprofit organizations that improve the quality of life in communities where employees live and work.

By leveraging matching gifts from the Thnvent Financial Foundation to support chantable causes, employees can help the foundation carry out its chantable mission and provide more assistance where it is most needed. Organization Information A Briefly summarize your organization's history, including the date your organization was established B Briefly summarize your organization's mission and goals C Briefly describe your organization's current programs or activities, including any service statistics and strengths or accomplishments Highlight new or different activities, if any D State your organization's relationship with other organizations working with similar missions What is your organization's role relative to these organizations'?

E List the number of board members, full-time paid staff, part-time paid staff and volunteers II. Purpose of the Grant Request A State the opportunity, challenges, issues or needs that your proposal addresses B Discuss how your focus was determined C State your overall goal s for the funding period D List the ways you will meet those goals E.


State the activities for which you seek funding and who will carry out these activities F State the time frame in which this will take place G Discuss how the proposed activities will benefit the community in which they occur. Be as clear as you can about the impact you expect to have H State your long-term funding strategies if applicable for sustaining this effort III.

Evaluation A Describe your criteria for success What do you want to happen as a result of your activities?

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You may find it helpful to describe both immediate and long-term effects B How will you measure your success? C Who will be involved in evaluating your work staff, board, constituents, community, consultants? D What will you do with your evaluation results?

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General Operating Proposals 1 The opportunity, challenges, issues 01 need cunently facing your oiganization 2 Oveiall 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-tenn funding strategies 7 Additional information legarding general operating proposals required by each individual funder B.

All Other Proposal Types 1 Situation a The opportunity, challenges, issues or need and the community that your pioposal addresses b How that focus was determined and who was involved in that decision-making piocess a Overall goal s regarding the situation described above b Objectives or ways in which you will meet the goal s c Specific activities for which you seek funding d Who will carry out those activities e Time frame in which this will take place 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 g Long-term funding strategies if applicable for sustaining this effort Minnesota Common Grant Application Form Contributions can be made to one or more eligible recipient organizations as often as desired during the year, up to the employee's gift matching maximum.

If you currently serve on the governing board of the organization receiving your contribution, the Foundation's match will be doubled up to the employee's gift matching maximum. Premiums should be made payable to the organization receiving the gift. The organization will send the premiums to Thrivent Financial for Lutherans.

There is a S2C 00C maximum limit that any one organization may receive in matching gifis in a calendar year If your gifi is not matched by the program, you and the organization that received the gift will be notified.

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All matching dollars will be sent to the organization s an unrestricted gift The matched amount will not be applied to the contract The amount matched will be subject to the employee's gift-matching maximum and recipient organization's maximum I declare that neither I nor any nominee of mine will receive anything of value in return for this donation and that Thrivent Financial Foundation's matching contribution will not be used to discharge any obligation that I or any other person may have I understand that only the tax-deductible portion of my donation is eligible for matching gifts Signature of donor Date of donation As the recipient organization, you must complete Part II and send the application to - Employee Gift Matching Thrivent Financial for Lutherans Foundation N.

Part II - Completed by Recipient Organization As an authorized official of this organization, I certify that the described gift was received by Name of recipient organization E-mail of organization contact Federal Tax ID required Address City State ZIP code A copy of the current c 3 letter or other proof of c 3 exemption must be included with the application in order to process the request. I certify that this organization is recognized by the IRS as a c 3 organization which is not a private foundation or a "supporting organization" under a 3 and that neither the donor nor a family member of the donor will derive any personal benefit from this donation or match.

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Dl ,ies. Luther Manor Foundation Incorporated! I1j 3. J 10 -jO. If any boxes are checked, the corporation must file Form even if it does not owe a penalty see instructions The corporation is using the adjusted seasonal installment method The corporation is using the annualized income installment method The corporation is a "large corporation" figuring its first required installment based on the prior year's tax a b c d 9 Installment due dates. Enter in columns a through d the 15th day of the 4th Pom?

Complete lines 12 through 18 of one column before going to the next column 12 Enter amount, if any, from line 18 of the preceding 12 3, If line 1 5 is less than or equal to line 10, subtract line 15 from line 10 Then go to line 12 of the next column Otherwise, go to 17 18 Overpayment.