AQHF Grant Application

GRANT PROPOSAL CHECK-LIST
Questions or inquiries may be directed to the Programs Office at (806) 378-5040.
Cover Sheet
Complete and submit the attached cover sheet which requests all pertinent contact
information needed for the grant evaluation process.
Program Description
Two-page narrative describing organization’s establishment with year of inception,
mission statement, current services provided and program’s goals and objectives.
Facilities Description
Half-page narrative describing organization’s facility, including location, shelters,
number of horses and their care, along with related management practices.
Project Request
Half-page narrative describing the educational coursework for which you are
requesting grant funding, and a timeline for completion.
Budget Forms
Complete and submit the enclosed organizational financial summary and training
budget forms (two pages). Information should be reported using the standardized
forms provided.
IRS Determination Letter
Applicants are required to be a 501(c)(3) not-for-profit organization as determined
by the Internal Revenue Service. A copy of this determination letter must
accompany your proposal.
Copy of Membership Card(s)
Applicant organizations must provide copy of a current membership through the
associations listed within criteria.
Copy of Clinician Resume and Syllabus
This section is only applicable to organizations applying for funding to provide
Center Immersion Training. Organization must submit copy of the clinician’s resume
and a training syllabus.
INCOMPLETE OR LATE APPLICATIONS WILL NOT BE CONSIDERED

2016 AHC COVER SHEET
Organization Name: Chakota Therapeutic Riding Center, NFP
Request Amount: $6550 Tax ID#:
Office Address:
6248 Wesclin Rd
Germantown, IL 62245
Phone: 618-334-0885
Website: www.chakota-trc.org
Fax: None
Contact(s):
Kay Langenhorst
618-334-0885
KayL@chakota-trc.org
Lynn Riddell
618-531-2305
LynnR@chakota-trc.org
Name & Tittle of Official to be Notified
if Grant is Awarded:
Kay Langenhorst
Executive Director
618-334-0885
KayL@chakota-trc.org
Association Membership: AHA CHA EAGALA PATH
INTL.
CERTIFICATION BY APPLICANT AND AUTHORIZATION
We certify the statements recorded in this proposal/application are true and accurate and
is submitted with our Board of Directors/Governing Body’s full knowledge and
endorsement. We understand if any statement presented in this proposal/application is
misleading or untrue, the applicant organization may be disqualified.
Organizational Representative:
Title or Office Held:
Signature: Date:
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Program Description
Chakota Therapeutic Riding Center is a non-profit organization located in
Germantown, Illinois 40 miles east of St. Louis. The program started in 1999, when Dave
Langenhorst volunteered at another Therapeutic Riding Center, Mounted Miracles, located
in Addieville, IL. He fell in love with the program and dreamed of starting his own program
here in Clinton County. In 2002 he returned to the program with his Fiancé and discovered
that the program had to close due to medical issues of their Founders. While returning
home, the two discussed the possibility of starting their own program at their current farm.
After numerous discussions, they decided to seek out training from Professional
Association of Therapeutic Horsemanship International (PATH intl.), formally known as
North American Riding for the Handicapped Association (NARHA). The training consisted
of several years of intense learning; attending workshops, conferences, and certifications
in order to safely mount their riders on their horses for the first time. On June 14, 2005, the
co-founders sent out thirteen personal letters to local medical and business professionals.
Thirty-four individuals from around the county attended and Chakota had its first
impromptu board meeting that evening. During the board meeting, it was decided that
Chakota would pursue the high standards and policies offered by NARHA and begin
offering Therapeutic Riding lessons. Following the board meeting, two years of planning
was done in order to build a facility to host a therapeutic riding sessions. It included
building a ten stall horse barn and put up fencing for the pasture. Once the facility was
ready, the first six week pilot program was launched in the Spring of 2007 with four riders
and two horses. These sessions were conducted during the weekends with the help of one
of the rider’s parents and a physical therapist assistant.
Chakota currently serves clients residing in Clinton, St. Clair, Washington, Bond,
and Madison County. Chakota’s mission is to provide equine-assisted therapy to
individuals with disabilities, such as Cerebral Palsy, Down Syndrome, Traumatic Brain
Injury, Autism Spectrum Disorder and others. Their goal is to expand their program to
serve as many people with disabilities in the surrounding area, with an objective of by the
end of the 2016 riding season to increase riding clients by ten riders. Chakota currently
offers therapeutic riding lessons to 22 clients with disabilities under the direction of the
PATH Intl. guidelines. Under the therapeutic riding program, Chakota currently has one
PATH Intl. certified riding instructor and serves each client once a week, weather
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permitting. They also offer mental and behavioral therapy through Equine Assisted Growth
and Learning Association (EAGALA), which is facilitated by a mental health specialist and
an equine specialist trained through EAGALA. Chakota currently have contracts between
one mental health specialist and two equine specialists who currently offer equine assisted
psychotherapy to three clients on a weekly basis.
Chakota Therapeutic Riding Center currently has seven key staff members
essential to Chakota’s success.
Dave Langenhorst, Co-founder, Equine Director, and EAGALA Equine Specialist,
brings vast horse knowledge to Chakota as he has worked with horses since he was nine
years old. He has experience in breeding and imprinting foals. He currently oversees all
horse training and maintains the health of the horses. Dave also assists in any barn
maintenance that is needed.
Kay Langenhorst, Co-founder, Executive Director, and EAGALA Equine Specialist,
has basic horse skills and advanced office skills. Kay currently oversees staff members,
volunteers, fundraising committee, and marketing committee. She also maintains all social
media sites. In the past, she has done the duties of program director and volunteer
coordinator and demonstrated customer service skills.
Michele Vargas, PATH Intl. Register Certified Instructor and Program Director, bring
a vast horse knowledge with riding and training since she was eight years old. Michele is
trained in a variety of riding styles, including Dressage, Hunter/Jumper, Western Pleasure,
and Western Speed. She has also taught abled-bodied riding lessons for numerous years.
Michele is the link to PATH intl. with her certification. In addition to horse skills, Michele
assists in the PATH intl. paperwork. She also assures the therapeutic riding program runs
smoothly and fosters growth.
Lynn Riddell has basic horse knowledge and proficient office skills. Lynn maintains
the volunteer, riders, and donor databases. She brings her technology knowledge to the
office and assures all office equipment is running properly. She also assists with grant
writing and fundraising.
Mark Langenhorst, Web designer, created and maintains the Chakota website.
Mark assures the information on the website is accurate and current. He is also the
administrator for the staff emails. He also brings horse knowledge and assists with riding
lessons as a horse leader.
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Chris Boenhoff, Barn and Maintenance Director, brings knowledge of building and
ground maintenance to Chakota. She also maintains the barns and grounds. Chris
currently manages the local lumber yard and coordinates building and maintenance days
at Chakota.
Chakota currently contracts with the Vorhees Wellness Center with the EAGALA
program. Jennipher Vorhees, MAPC, LCPC, and EAGALA Mental Health Specialist, brings
the equine assisted psychotherapy program to Chakota. She also markets this program to
a new set of potential clients.
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Facilities Description
Chakota Therapeutic Riding Center is located at 6248 Wesclin Rd, Germantown,
Illinois on 11.5 acres. This includes eight acres of pasture and a small hay field. The barn
is an all metal MD barn with concrete flooring. Currently there are nine 12 by 12 stalls, with
rubber mats and aisle feeder access. The barn also includes a hot and cold wash-bay,
tack room, office, and ADA compliant restroom. Attached to the horse barn is a hay barn
which includes a four stall lean-to which houses the horse trailer, tractor, and saw dust bin.
Therapeutic riding lessons are conducted in a 40’X80’ covered arena with rubber mulch
footing, with a 16’X80’ covered lean-to which houses the ADA compliant ramp, SureHands
lift, and parent viewing room. Chakota has twelve horses at their disposal which includes,
two miniatures horses, one pony, eight full size horses of different breeds, and one 17.2
hands Belgium draft horse. The routine care for all Chakota horses include quarterly
worming, farrier every six weeks, vet check and yearly shots, equine dentist every two
years. Daily feeding based on each horse’s needs include pelleted feed, minerals and
vitamins, high quality grass hay, and alfalfa hay when needed.
During the summer horses are brought into their own stalls for graining twice a day,
and returned to the pasture which includes two run-in shelters. In inclement weather,
including winter, horses are stalled. Barn and pasture maintenance is kept up to ensure
safety of horses including stripping and disinfecting every stall every spring and fall.
Chakota has acquired various donations or discounted items for the horses care.
These include 100 bales of donated alfalfa hay every year by a local farmer, discounted
grain from a local distributor, and on property hay field which produces large round bales
and square bales. Baling of the hay is also donated by a parent of a rider.
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TRAINING BUDGET
INDIVIDUALIZED EMPLOYEE/VOLUNTEER TRAINING
Clinic/Workshop Name: Equine Specialist in Mental Health &
Learning Workshop
Sponsor Association: (ex. AHA) PATH Intl.
Clinician/Trainer: (ex. John Smith) Dr. Leslie McCullough
Training Category: (ex. Muscles in Motion) Equine Specialist Workshop
Date(s) of Workshop/Clinic: June 16-19 2016
Amount per Attendee: $550
No. of Attendees: 2
Total Amount: $1100
Training Justification:
The Equine Specialist in Mental Health & Learning workshop is a three day
workshop that is the first step in certification as a PATH Intl. Equine Specialist. Chakota
Therapeutic Riding Center is in the process of launching an Equine Assisted Learning
program at their facility. In order to be PATH Intl. compliant the program requires one
professional certified as an Equine Assisted Learning Facilitator and one Equine Specialist
or one person dually qualified. After completely the workshop on must complete a portfolio
following the PATH Intl. guidelines within two years after the completion of the workshop
and two online tests within 60 days after the completion of the portfolio. If funding was not
obtained, Chakota Therapeutic Riding Center would have to postpone the program until
the organization had the funds to send two members to this or similar workshops.
Clinic/Workshop Name: PATH INTL. Annual Conference
Sponsor Association: (ex. AHA) PATH INTL.
Clinician/Trainer: (ex. John Smith) Various
Training Category: (ex. Muscles in Motion) Annual Conference and Meeting
Date(s) of Workshop/Clinic: November 1-5 2016
No. of Attendees: 5
Total Amount: $3150
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The PATH Intl. Annual Conference is a five day conference held every year in the
first week of November. The conference offers numerous educational sessions presented
by different professionals in different careers. These educational sessions have different
tracks such as instructor, equine, administration, and participant. These different tracks
offer different opportunities for the facility to grow with the knowledge learned. In addition
to new knowledge, the attendees will also earn continuing education hours that are needed
to keep current certifications, such as PATH Intl. registered certified instructor, EAGALA
Equine Specialists, and the previous mentioned PATH Intl. Equine Specialist in Mental
Health. If funding was not obtained, Chakota Therapeutic Riding Center would have to
fundraise to pay for the conference and encourage the staff members to apply for PATH’s
scholarship to attend their conference. If funding was not obtained through fundraising, the
staff members would have to find continuing education hours elsewhere and Chakota
would not gain the knowledge that would be obtained at the PATH Intl. conference.
Clinic/Workshop Name: Approved Training Courses
Sponsor Association: (ex. AHA) PATH Intl.
Clinician/Trainer: (ex. John Smith) Various
Training Category: (ex. Muscles in Motion) Approved Training Courses (ATC)
Date(s) of Workshop/Clinic: Various
No. of Attendees: 5
Total Amount: $2300
PATH Intl. approved training courses are online webinars that are offered through
PATH Intl. These training count as continuing education hours that are necessary to keep
certain certifications. Each professional with a certification are required to earn twenty
continuing educational hours by the end of October when he/she reapplies for his/her
PATH Intl. membership. The trainings are very informative and increase the knowledge of
the professionals that do watch the webinar, but the previous mentioned PATH Intl.
Conference offers greater knowledge and an opportunity to network. If Chakota
Therapeutic Riding Center did not receive funding, Chakota would have to look for funding
elsewhere or each individual would have to find their own funding to pay for trainings or
pay out of pocket.
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ORGANIZATIONAL FINANCIAL SUMMARY
Accounting Year Dates (Fiscal/Calendar): Calendar (Jan. 1, 2016 – Feb. 22, 2016)
INCOME
Items that should be included as income: fees for client services, proceeds from an event,
government grants, foundation grants, individual donations, etc.
Income Type Prior Year’s
Actual ($)
Projected Annual
Budget ($)
YTD Actual ($)
Revenue (earned income) $4,319.49 $22,007.84 $100.78
Special Events $31,153.49 $41,570.00 $5,040.00
List # of events per year 8 7 3
Support (donations, grants, etc.)
Federal $0.00
Public & Private $45,963.97 $29,978.00 $2,622.66
TOTAL INCOME $81,436.95 $93,555.84 $7,763.44
Explanation of Income: Therapeutic Horseback Riding Sessions, Therapeutic Off-Horse Sessions,
Able-bodied Horseback Riding Sessions, Pony Camps, Group Field Trips
EXPENSES
Items that should be included as expenses: salaries, supplies, rent and utilities, veterinary care,
feed, service fees, insurance, fundraising events, volunteer education, center certifications, etc.
Expense Type Prior Year’s
Actual ($)
Projected Annual
Budget ($)
YTD Actual ($)
Operating
Instructor Salaries $29,100.00 $36,360.00 $8,060.00
Other Payroll/Salaries $1,531.44 $1,375.00 $0.00
Office & Educational Supplies $6,060.87 $4,009.00 $1,083.37
Facility (rent and/or repairs) $6,034.97 $3,320.00 $1,903.74
Utilities $6,161.83 $5,937.44 $1,259.43
Horse Care $7,343.02 $2,500.00 $559.56
Other/Miscellaneous $11,219.66 $14,400.00 $1,010.20
Insurance $6,898.80 $9,938.40 $2,053.60
Fundraising $6,579.83 $10,530.00 $891.96
Education & Certifications $4,822.78 $600.00 $600.00
Capital Expenses $0.00 $0.00 $0.00
TOTAL EXPENSES $85,753.20 $88,969.84 $17,421.86
Explanation of Expenses: Salaries, Commissions, Supplies, Repair, Utilities, Veterinary Care,
Horse Feed, Insurance (W/C, Liability & Director/Officer), Fundraising, Certification, Facility
Building Additions
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