Cops For Kids Grant Request Form
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1. Grants will be awarded in two granting periods; one in the spring (March) and one in the fall
(September). Grant requests must be submitted to the Indiana State Police Alliance (ISPA) by the
end of February for the spring granting period, and by the end of August for the fall granting

2. Grant requests will be considered only when the application clearly indicates that the following
criteria has been met:
a. All funding requested will be used to purchase specific items for use by children 18 years
old and younger. Grants will not be considered when funding will be used for
administrative costs, fees, travel expenses, sponsorships, fundraising drives, or any nontangible
b. The requesting organization is a non-profit organization.
c. The requesting organization is in some manner affiliated with a member of the Indiana
State Police Department. This organizational affiliation may be formal (direct
participation), such as a coach, board or committee member, or adult supervisor with the
organization, or it may be an informal (indirect participation) affiliation, such as a parent
of a child participant, or merely a concerned/supportive member of the community.
d. The grant request is endorsed by a director or representative of the ISPA. (Note: the
organization’s Indiana State Police affiliate should know of the appropriate ISPA
Director or Representative to contact. If not, that person may contact the ISPA office for

3. If approved, certification as to proper use of funds must be submitted within thirty days of the
initiation of the program/event. A certification form will be enclosed with the grant check and
must be returned with receipts as applicable to 1415 Shelby Street, Indianapolis, IN 46203.
a. Failure to provide timely certification will cause the organization to be ineligible for
further grants for a period of three years from the date the grant was approved.

4. Only one grant per organization will be considered within any twelve month period.

5. If a grant request is denied, the organization may appeal the denial within thirty days through
written correspondence to the ISPA Executive Board.

6. Any request for financial assistance tabled by the ISPA Executive Board for further information,
will be carried on the agenda for two meetings. If the requester provides no follow-up, the
request will be removed from the agenda for further consideration.

7. If the program/event is not held, the requesting organization is responsible for refunding all
monies granted.
Name Of The Requesting Organization *
Name Of The Requester *
Signature Of The Requester (digital) *
Relationship To The Requesting Organization *
Requester Telephone Number *
Requester Email Address *
Make Check Payable To: *
Mail Check To (Full Address) *
Purpose Of Funds (List Each Item, Cost, and Proposed Use) *
Program Or Event For Which The Funds Will Be Used *
Number Of Children That Will Benefit *
Date Of Program/Event *
Amount Requested (Exact) *
Indiana State Police Affiliation *
Acknowledgment *
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