MICHAEL E. SMITH ENDOWMENT FOR EXCELLENCE IN EDUCATIONSTANDARD APPLICATION FOR PROGRAM GRANTS

PART I – GENERAL                                                                                                    

 

A.  APPLICANT:                                                                                                                SCHOOL:                                       GRADE: 

 

 

ADDRESS:

 

 

 

TELEPHONE:  (               )                                                                                         E-MAIL ADDRESS:

 

 

 

B.  APPLICATION FOR PROGRAM FUNDING

 

 

 

 

 

PROGRAM NAME

 

 

PROJECT DURATION

FROM      -       TO

 

 

AMOUNT

REQUESTED

 

FY2006 -2007

 

 

 

 

 

 

 

 

 

C.    I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS CORRECT AND COMPLETE.

 

 

PRINCIPAL  SIGNATORY:

 

TITLE:

 

TYPED NAME:

 

DATE:

 

 

ALL APPLICATIONS FOR CONSIDERATION SHOULD BE POSTMARKED

Friday, March 15, 2013.

Mail the proposal listed on this signature page to:

Michael E. Smith Endowment for Excellence in Education

C/O Pam Simpson 1 Silverwood Terrace
South Hadley, MA  01075

 

 

Number of copies:  Two (2) sets, each with an original signature of the School Administrator

 

DO NOT WRITE BELOW THIS LINE

 

 

 

OFFICIAL USE ONLY

 

GRANTS MANAGEMENT

 

Date received:

 

Project Number:

 

 

MICHAEL E. SMITH ENDOWMENT FOR EXCELLENCE IN EDUCATION

APPLICATION FOR FUNDING

 

 

PART 11 – PROGRAM DESCRIPTION

 

1)      Briefly describe the program and the goals of the program.  Indicate how many students will be impacted by the program.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2)      What is the connection of this project to the curriculum?

 

 

 

 

 

 

 

 

 

 

 

 

 

3) What methods will you use to assess the success/effectiveness of this program and report back to the community?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4) Can this program be replicated and/or the results utilized to enhance the learning of other students who are not directly involved in the initial program?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5)  Have you applied to any other agencies for funding of this program in the past.  Please provide a brief summary.  

 

 

 

 

 

 

 

 

6)  If applicable, have you received multiple quotes for the resources you need? (Please attach with financial  information)

 

Michael E. Smith Endowment for Excellence in Education

Application for Funding

Budget Detail

Part III – Financial Information

 

 

School:

 

Grade:   

Teacher:

 

Address:                                                                   Zip Code:

 

Telephone:  (          ) 

 

E-mail address:          

 

 

Please provide an itemized budget.  Use this page and additional sheets if necessary.  Include the following categories:

 

A.) Stipends for personnel (instructional and professional staff, support staff, outside speakers, and others).

 

 

 

 

 

 

B.) Supplies and equipment.

 

 

 

 

 

 

C.) Travel.

 

 

 

 

 

 

D.) Other costs.

 

 

 

 

 

E.) Total funds requested.

 

 

 

If there are no expenses in a given category, simply write NONE.

Please ITEMIZE expenses in all other categories