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Grant Application

Please read the Grant Guidelines before completing and submitting your application. Grant Applications are considered on a first-come, first-served basis and are awarded based on merit and availability of funds.

Applicant Info

Date Submitted:
Name of Applicant:
Job Title:
Organization:
Address:
City:
State:
Zip:
Phone:
Fax:
E-mail Address:
Project Partners - List other key project partners:

Project Description

Project Title:
Project Start Date:
Project End Date:
School/Schools Where Project Will be Implemented (check all that will apply):
DCAS KHES NHES FFES MES CHES	FFMS MMS CHSS FFHS MHS
Total # of students to be impacted:
Grade Level(s) of Students to be impacted:
Curriculum Area:
Is this a new project/program/initiative? Yes No
List the 21st Century Content Area(s)your Project will target(see application guidelines).

List the 21st Century Learning and Skill Mastery Area(s) your project will target(see application guidelines).

21st Century Project Goals

21st Century Project Objectives

21st Century Project Strategies

How will you evaluate the project?


Project Budget

Curriculum Materials Amount: $ Brief Description: Source:

Equipment Amount: $ Brief Description: Source:

Material and Supplies Amount: $ Brief Description: Source:

Food/Beverage Amount: $ Brief Description: Source:

Honorariums/Stipends Amount: $ Brief Description: Source:

Contracted Services Amount: $ Brief Description: Source:

Travel Expenses Amount: $ Brief Description: Source:

Printing Amount: $ Brief Description: Source:

Postage Amount: $ Brief Description: Source:

Other Amount: $ Brief Description: Source:

Total Project Budget: $
Total Requested from DEF: $

Certification

Single School Projects: By checking this box, I (the applicant named above) certify that I have approval from the Principal of the School referenced above to apply for this grant and to implement this project in same school if this project is funded.

Multi-School/District-wide Projects: By checking this box, I (the applicant named above) certify that I have approval from all Principals of the Schools referenced above to apply for this grant and to implement this project in same schools if this project is funded. I also certify that I have approval from the appropriate Director of Curriculum Instruction for this multi-school project.

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