Section 1 of 4
Contact information
Please answer the questions as fully as possible and submit this form to apply for a Pay It Forward grant
Your Name
Your Name
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Your Email
Your Email
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Your phone number:
Your phone number:
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Name & denomination of congregation:
Name & denomination of congregation:
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Congregation address:
Congregation address:
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Your Role/Position in the Congregation:
Your Role/Position in the Congregation:
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Section 2 of 4
Your Building
Approximate age & size of your building(s):
Approximate age & size of your building(s):
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Approximate number of members/weekly attendees:
Approximate number of members/weekly attendees:
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Name of facilities manager, property committee &/or green team chair (include title):
Name of facilities manager, property committee &/or green team chair (include title):
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Other uses of your building; Approx. hours/week:
Other uses of your building; Approx. hours/week:
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A rough estimate of your annual (or monthly) energy use: electric, gas, other (2018):
A rough estimate of your annual (or monthly) energy use: electric, gas, other (2018):
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Section 3 of 4
Your Request
How much are you requesting, and what will it be for? (1 sentence)
How much are you requesting, and what will it be for? (1 sentence)
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Are there other sources of funding available for this project? Explain, if so:
Are there other sources of funding available for this project? Explain, if so:
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How might this project help your congregational members, your congregation's neighbors, your denomination, and/or the broader community?
How might this project help your congregational members, your congregation's neighbors, your denomination, and/or the broader community?
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Might your congregation be willing to “pay forward” a fraction of the benefits received through this grant? (Consider a small financial contribution to the PIF fund in the future.)
Might your congregation be willing to “pay forward” a fraction of the benefits received through this grant? (Consider a small financial contribution to the PIF fund in the future.)
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Section 4 of 4
Next steps
Earth Care Bloomington has considerable energy-related experience which we will be happy to share. Members of our Green Team have made presentations on congregational energy, from small energy-saving strategies all the way to solar installations.
Earth Care Bloomington has considerable energy-related experience which we will be happy to share. Members of our Green Team have made presentations on congregational energy, from small energy-saving strategies all the way to solar installations.
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Please communicate with people in your congregation who can help plan and implement your project. This may include clergy, facilities manager, members of your property committee, green team, trustees, administrative body, and any members of your congregation who have construction or engineering experience.
Please communicate with people in your congregation who can help plan and implement your project. This may include clergy, facilities manager, members of your property committee, green team, trustees, administrative body, and any members of your congregation who have construction or engineering experience.
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A member of Earth Care will contact you to set up a time to meet at your building or virtually (e.g. Zoom or Skype) to review your request and answer any questions that arise. At that time we will have you suggest several possible times to meet or talk. (Perhaps create a Doodle poll in which Earth Care members could participate).
A member of Earth Care will contact you to set up a time to meet at your building or virtually (e.g. Zoom or Skype) to review your request and answer any questions that arise. At that time we will have you suggest several possible times to meet or talk. (Perhaps create a Doodle poll in which Earth Care members could participate).
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