Lucille Allen Hadley Youth Service Award
“Taking Service Learning to the Next Level”
Application
Description
The objective of this award is to provide a service learning opportunity to teens participating in Regional Teen Conference service projects. It is Lucille Hadley’s hope that this award enables Jack and Jill chapters an opportunity to establish lasting relationships with local organizations. The ultimate goal is to leverage the funds and manpower donated with other companies to provide as much assistance as possible for community organizations in need.
General Information
Region: ______Regional Director: ______
Host Chapter: ______
Chapter President: ______
Teen Sponsor(s):______
Who should be contacted if there are questions about this application? (Give full name, title, address, phone and fax)
Name:______Title: ______
Address: ______
Phone: ______Fax: ______
Total project cost: _$______Date of Event______
Amount requested ($3,000 maximum):______
(70% awarded before, 30% after)
Project information
Description of project (attach sheets as necessary)
1)Provide a brief description of your chapter and include officers, mothers, teens, etc.
2)Describe the “Day of Service Project” to be performed by your region. Include objective to be accomplished by this service learning project.
3)What relationships have been established with this local agency/organization?
4)What long term community impact will continue after the TeenConference ends?
5)Which local partnerships have been established? Will these local agencies assist in donations (in-kind and/monetary)?
6)Provide a budget (estimated expenses) for your project.
7)What types of media coverage have been arranged (minimum of 3) Provide contact names, locations, etc. Include sample public service announcements.
Guidelines
Impact priorityTeens and local organizations
Impact ApproachService Learning
Maximum number of 1 per region per program year
grants awarded
Who can applyJack and Jill chapters hosting Teen Conference
Application deadlineAs requested
Funding periodFoundation Fiscal Year: 12 months
Renewal deadlineNon-renewable
Grant does not fundScholarships, equipment, capital costs, staff salaries/wages, political activities, endowments, individuals
Required support signaturesRegional Director, Chapter President and Teen Sponsor
Send Application toFoundation headquarters and Regional Member-at-Large
Authorized signatures (Sign in blue ink)
I certify that the above information is true to the best of my knowledge and is submitted with the support and formal approval of our Regional and Local Chapter officers. In addition, submission of this proposal confirms our agreement to comply with all general and specific grant guidelines, policies and restrictions mandated by Jack and Jill of America Foundation, Inc. Furthermore, I certify that no members, officers, or employees represent conflict of interests.
Signature of Regional Director
______
Sign on Above LineType Name Here: Date
Signature of Chapter President
______
Sign on Above LineType Name Here: Date
Signature of Teen Sponsor
______
Sign on Above LineType Name Here: Date