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1 / 1 3 / 2 0 2 6 P a g e 1 I 7 SRD Board Members Jan Brenner Tasa Brost Kristin Fong Larry Gerber Tom Keegan Rick Lasko Matt McFadden Tia Mitchell Jay Nielson Ty Pedersen Josh Spinney Emily Swett Kelly Shoshone Recreation District 1402 Heart Mountain St PO Box 1531 Cody WY 82414 307/527-3485 [EMAIL REDACTED] Catherine Glenn Administrative Coordinator 307/527-3486 [EMAIL REDACTED] Mike Fink Director Shoshone Recreation District Grant Form FY 2026-2027 Shoshone Recreation District (SRD) is Seeking Proposals for Funding from Groups & Organizations within Park County School District 6 Boundaries Recreation oriented, non-profit organizations within the boundaries of Park County School District 6 are invited to apply for funding. The Shoshone Recreation District supports healthful and creative recreation programs, facilities, and activities to enrich the lives of the residents of Park County School District 6. Application Deadline Friday, March 13, 2026, 4:00 PM. Grant money can be spent July 1, 2026 – June 30, 2027. AN INCOMPLETE APPLICATION WILL NOT BE CONSIDERED. SRD funds items such as: • general liability insurance • equipment, facility rental or use costs SRD does NOT fund: • salaries, contract labor • directors’ and officers’ insurance • scholarships • items for resale SRD does not reimburse; SRD must pay all vendors directly. To be considered for a grant, please provide the following detailed information relating to your request and organization: 1. Submit a completed application form with relevant attachments before deadline. Applications are available on the City of Cody website http://www.codywy.gov/175/Shoshone-Recreation-District. Send, email or deliver to: Mail: Shoshone Recreation District, PO Box 1531, Cody WY 82414 Email: [EMAIL REDACTED] Call and confirm email submittals were received. Or deliver to: Cody Recreation Center, 1402 Heart Mountain Street Attention: Shoshone Recreation District Questions: Catherine Glenn 307/527-3485 2. Applicants will be notified by mail, telephone or e-mail after the board has reviewed all applications. At the discretion of the SRD Board, group presentations and interviews may be required. If a presentation is required, the organization will be contacted and presentations will be scheduled on the evening of Wednesday April 15th (time TBD). Please feel free to attach any additional information to your application you believe would be relevant to your grant request. ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 2 I 7 (Please type or print legibly) Name of Group/Organization Requesting Funding Primary place of group/organization must be within Park County School District 6 boundaries (contact our office if your organization has questions regarding the Park County School District 6 boundaries) Is your organization incorporated as a non-profit organization under WY State Law and/or IRS status? Type of non-profit organization--please explain: Non-profit with IRS 501 3 STATUS Federal Tax Identification Number: Other (please indicate): How long has your organization been in existence? Years Is this your first year completing a SRD application for funding? Please list last 3 years of SRD funding amount(s) if Is your organization within Park County School District 6 Boundaries? Mailing Address City/State/ZIP Contact and Authorized Representative Name & Title Phone(s) E-Mail Secondary Contact and Representative Name & Title Phone(s) E-Mail Grant amount being requested: $ Name of Project or Program: ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 3 I 7 1. What is the primary purpose (recreation services) of your program, or project, and how does it support the purpose of the SRD which “supports healthful and creative recreation programs, facilities, and activities to enrich the lives of the residents of Park County School District 2. Does your organization make scholarships available to participate regardless of inability to pay? Please explain 3. Is there a selection or tryout process that limits the number of individuals involved that can participate? If yes, explain. ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 4 I 7 4. Why should this program or project be funded? 5. Is this a one-time request or will future funding be needed to continue this project? 6. Please explain your future plans for sustainability (financial or otherwise). 7. What percentage of your Board Members volunteer to your organization or contribute to your organization financially? 8. Describe other financial contributions, including in-kind, which have been or will be made toward this project, if any. Will any of the funding requested be used for grant matching funds? If yes, please provide list of grantor names, project description, grant amounts, and matching requirements. ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 5 I 7 9. How many Park County School District 6 residents and non-residents are served in your organization and how many people do you expect to participate in your program. Estimated Number of PC School District 6 Residents Non- Residents Number of Program Days Age Groups Served Participant Registration Fees Per Participant 2026 or 2027 Projected this year 2025 Last year actuals 10. Purpose of funding or how will the grant be used to enhance your program (please be specific): A. Vendor/Item/Equipment Quantity Cost Shipping Total Example: Rawlings Baseballs 1 bucket – 24 Balls Each Bucket $110.25 $10.00 $120.25 Total Equipment B. Liability Insurance Coverage Total C. Field or Facility Fees Description of Use Total Multiple Bids would be warmly accepted. Please feel free to attach bids for equipment. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 6 I 7 D. Other Please list in detail (Attach copies if necessary) Total Total above, grant amount being requested (A+B+C+D) Is it feasible to purchase equipment/materials in Park County School District 6? If No, please explain: 11. Budget Summary- (attach additional information if necessary) Applicant Income Source(s) Committed or Requested Funds July 1 – June 30 1. Grants, Contributions $ Foundations, Recreation District(s) Please list funding use & indicate requested or approved. $ 2. Sponsors $ 3. Other (specify) $ 4. Earned Income Player & Entry Fees $ Events, Fundraisers $ 5. In-Kind Support $ 6. Current Cash Balance $ TOTAL INCOME $ Do you have a reserve fund or end of year cash balance: If yes, do you have a board approved plan for said reserves? Please briefly explain: 0.00 0.00 ---PAGE BREAK--- 1 / 1 3 / 2 0 2 6 P a g e 7 I 7 Expenses Applicants Budget July 1 – June 30 The totals below should reflect the items shown on pg. Purpose of Funding 1. Salaries & Benefits $ Not eligible 2. Contracted Services $ Not eligible 3. Advertising & Printing $ $ 4. Scholarships $ Not eligible 5. Repairs & Maintenance (Vehicles, etc.) $ $ 6. Equipment, Materials & Supplies $ $ 7. Liability Insurance $ $ 8. Field or Facility Rent $ $ 9. Machinery/Equipment $ $ 10. Travel Costs $ $ 11. Dues & Fees $ $ 12. Other Expenses (please describe) $ $ TOTAL EXPENSES $ $ Total SRD Funding Requested Authorization: I certify that all of the information provided on this application is true and complete to the best of my knowledge. Liability and/or event insurance coverage is also required for the organization identified on this application. I understand that if asked by an authorized official of the Shoshone Recreation District, I agree to give proof of the information that I have given on this application and to provide certificate of liability insurance, coverage period and type of coverage. Your group/organization agrees to indemnify the Shoshone Recreation District of any liability associated with the use of such funds and certifies that this grant request has been approved by your governing board(s). Individuals participating in recreational activities sponsored by the SRD agree to hereby operate in accordance with the code of ethics: provide positive support, care, and encouragement for fellow competitors and league officials. Treat other players, coaches, fans, and officials with respect; demonstrate fair play and sportsmanship to all fellow competitors; understand that the officials are there for the participants benefit and will agree not to direct any profane or threatening actions toward them (either verbal or physical). Violations may result in a denial of future funding. Date: Organization Requesting Funding: Authorized Representative’s Signature: Title: 0.00 SIGN Submit Form