/ Ashland Schools Foundation
2017-18

Impact Grant Application Form

/ ASF USE ONLY
Grant #: ______
Date Rec’d: ______
Action: ______
Date:______
Assigned to:
______

Part A - Summary

1. Project Title: / 2. School:
3. Project Start Date: / 4. End Date:
5. Total amount requested(whole $): / $ / [Please fill out budget form with your application.]
6. Name(s)
LEAD TEACHER (for communications): /

Grade / Subject (if app)

/ Work Phone & Extension / E-Mail
(if other than standard school email)
ADDITIONAL ASD TEACHERS:
7. Brief Summary of the Project: / *No more than 2-3 lines, you may expand your description in section “B”.
8. How many students will this project serve directly? / Indirectly?
Generally, who are the indirect students?
Example: Students learn a skill (direct benefit) and then teach younger students in the school (indirect benefit.)
9. Which curricular area(s) does this project address?
Math / Lang. Arts/World Lang. / Science / Health/PE
Fine Arts / Professional / Technical / Soc.Studies/History / Other?
(Describe below)
10. Additional Comments (if desired):

Part B – Grant Description

Type in the white areas below the questions - boxes will expand with your text.
Try to keep this to two pages.
1. Describe the project. (Please give a complete description of grant activities. i.e. What will students be doing?)
2. Will you be hiring any personnel for this grant? Please tell us who they are and give a short bio of theirprofessional or personal qualifications, or experience that makes them your choice for this grant activity. If you are still searching for your personnel, please let us know what criteria you are looking for in your expert.
3. Explain how the project addresses the class or school-wide curricular goals. What is the enrichment objective you intend to address?
4. Because ASF grant funds rely on donor donations, it is important that use of grant funds is publicized to our community. If you are awarded an ASF Impact Grant, you will be required to publicize your grant and ASF’s funding role in the following three ways:
(1) Notify the parents of your students (could be as simple as a “Hey we got an ASF grant for this awesome project” email)
(2) Submit an article about the grant to your school’s newsletter; be sure to mention ASF’s funding role (submit copy to ASF)
(3) Notify local media about your grant activity. ASF will try to help you with this if you let us know when your activities are taking place.
Describe below any publicity/media opportunities that may occur during project activities, or other additional ideas you might have for promoting this grant to our parents and greater community.
5. Explain how, if at all, local community members will be involved in the project.
6. Explain how you will evaluate the success of the project.

Part C – Applicant’s Signature

I hereby confirm that the grant application that
I have submitted meets the criteria of the
Ashland Schools Foundation and that I have read and agree with the grant requirements. / (If no electronic signature, type in name below)
Electronic Signature 
Name:
School
Date:

Part D – Principal’s Concurrence

(If no electronic signature, type in name below)
I hereby confirm that the grant application that is submitted here meets the curriculum goals ofthe school and has the concurrence of the school administration and/or site council. / Electronic Signature 
Name:
School
Date:
APPLICATION DUE DATES:
Fall 2017: Wednesday, October4, 2017, midnight
Winter 2018: Wednesday, January 31, 2018, midnight

ASF Impact Grant Application Form 2017-18

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