Applications will be accepted from November 15, 2010 until January 31, 2011. May we suggest that you write out your proposal on a separate document and save it before copying it to the online form. All fields are required except the "comment" field at the end of the application.

School Name:
School district name:
Principal's name:
Contact person name:
E-mail Address:
School telephone Number:
School address:	(street)
	(address 2)
	(city) (state)
	(ZIP code)
Name of project:
Project description:
Amount requested:	($1,500.00 maximum)
Proposed itemized budget:
Grade(s) level:
Number of students reached by the project:
How the project's results will be evaluated:
Your comments:

Notice: If you have any questions or comments regarding this form, please send e-mail to: Lisa Perry