NEA CENTER FOR ORGANIZING

NEA LOCAL PRESIDENT RELEASE TIME PROGRAM GRANT

Applications must be submitted online by December 16, 2014.

CONTACT INFO

First Name: Click here to enter text.Last Name:Click here to enter text.

State Affiliate:Choose an item.Date:Click here to enter text.

GENERAL APPLICATION QUESTIONS

  1. What is the name of the Local Association?Click here to enter text.
  2. What is the address of the Local Association?Click here to enter text.
  3. What is the email address for the Local Association?Click here to enter text.
  1. What is your NEA region? Choose an item.
  1. Please check which grant application type you are seeking:
  2. Full-Time
  3. Part-Time
  1. Do you currently provide release time for your local president?Choose an item.
  2. If yes, please provide the release time information (Hrs./Days). Click here to enter text.
  3. What is the annual total cost of the current release time (if any) to the local association? Click here to enter text.

MEMBERSHIP

  1. What were the total figures for the LAST Membership Year? Click here to enter text.
  2. K-12
  3. Potential: Click here to enter text.
  4. Actual: Click here to enter text.
  5. Agency Fee Payers: Click here to enter text.
  1. Education Support Professionals:Click here to enter text.
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.
  1. Higher Education:Click here to enter text.
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.
  1. Administrative:
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.
  1. What were the total figures for the CURRENT Membership Year? Click here to enter text.
  2. K-12
  3. Potential: Click here to enter text.
  4. Actual: Click here to enter text.
  5. Agency Fee Payers: Click here to enter text.
  1. Education Support Professionals:Click here to enter text.
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.
  1. Higher Education:Click here to enter text.
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.
  1. Administrative:
  2. Potential: Click here to enter text.
  3. Actual: Click here to enter text.
  4. Agency Fee Payers: Click here to enter text.

CURRENT LOCAL DUES STRUCTURE

  1. Please provide dues figures:
  2. K-12
  3. Last Year Local: Click here to enter text.

Current Year Local: Click here to enter text.

  1. Last Year State:Click here to enter text.

Current Year State:Click here to enter text.

  1. Last Year National (NEA): Click here to enter text.

Current Year National (NEA):Click here to enter text.

  1. Last Year Other (Regional, UniServ, etc.): Click here to enter text.

Current Year Other: Click here to enter text.

  1. Education Support Professionals:
  2. Last Year Local: Click here to enter text.

Current Year Local: Click here to enter text.

  1. Last Year State:Click here to enter text.

Current Year State:Click here to enter text.

  1. Last Year National (NEA): Click here to enter text.

Current Year National (NEA):Click here to enter text.

  1. Last Year Other (Regional, UniServ, etc.): Click here to enter text.

Current Year Other: Click here to enter text.

  1. Higher Education:
  2. Last Year Local: Click here to enter text.

Current Year Local: Click here to enter text.

  1. Last Year State:Click here to enter text.

Current Year State:Click here to enter text.

  1. Last Year National (NEA): Click here to enter text.

Current Year National (NEA):Click here to enter text.

  1. Last Year Other (Regional, UniServ, etc.): Click here to enter text.

Current Year Other: Click here to enter text.

  1. Administrative:
  2. Last Year Local: Click here to enter text.

Current Year Local: Click here to enter text.

  1. Last Year State:Click here to enter text.

Current Year State:Click here to enter text.

  1. Last Year National (NEA): Click here to enter text.

Current Year National (NEA):Click here to enter text.

  1. Last Year Other (Regional, UniServ, etc.): Click here to enter text.

Current Year Other: Click here to enter text.

FIRST AND SECOND YEAR COST OF A RELEASED PRESIDENT

  1. Total Cost(funding from the school district/institution should not be included)?Click here to enter text.

(Identify Total Cost by checking the appropriate box below)

  1. Salary and Benefits
  2. Substitute Pay or Replacement Cost
  1. NEA Cost: Click here to enter text.

Full-Time: Multiply total in Line 1 by 0.45/Maximum = $25,000

Part-Time: Multiply total in Line 1 by 0.45/Maximum = $12,500

  1. State Cost: Click here to enter text. (Full and Part Time: Multiply total in Line 1 by percentage the state has agreed to pay (must be at least 10%)
  2. Local Cost: Click here to enter text.(NEA Cost + State Cost)
  3. Local’s Responsibility: Click here to enter text.

Full and Part Time: (Divide total in Line 4 (Local Cost) by total in Line 1 (Total Cost) x 100

THIRD YEAR COST OF A RELEASED PRESIDENT

  1. Total Cost (funding from the school district/institution should not be included)? Click here to enter text.

(Identify Total Cost by checking the appropriate box below)

  1. Salary and Benefits
  2. Substitute Pay or Replacement Cost
  1. NEA Cost: Click here to enter text.

Full-Time: Multiply total in Line 1 by 0.30/Maximum = $16,500

Part-Time: Multiply total in Line 1 by 0.30/Maximum = $8,250

  1. State Cost: Click here to enter text. (Full and Part Time:Multiply total in Line 1 by percentage the state has agreed to pay (must be at least 7%)
  2. Local Cost: Click here to enter text.(NEA Cost + State Cost)
  3. Local’s Responsibility: Click here to enter text.

Full and Part Time: (Divide total in Line 4 (Local Cost) by total in Line 1 (Total Cost) x 100

FOURTH YEAR COST OF A RELEASED PRESIDENT

  1. Provide a projection of costs and funding sources for year four of the release time. Click here to enter text.
  2. Outline procedures that are being developed/implemented to ensure continuation beyond the third year: Click here to enter text.

FIFTH YEAR COST OF A RELEASED PRESIDENT

  1. Provide a projection of costs and funding sources for year five of the release time. Click here to enter text.
  2. Outline procedures that are being developed/implemented to ensure continuation beyond the third year: Click here to enter text.

PLEASE PROVIDE A THREE-YEAR DESCRIPTIVE PLAN THAT SHOWS YOUR LOCAL’S COMMITMENT TO PROVIDE FUNDING: Click here to enter text.

PROGRAM GOALS AND OBJECTIVES

Describe what is currently being done or how the grant will assist with the following program goals and objectives.Program goals and objectives reflect the local’s commitment to NEA’s Strategic Focus, Plan, and Priorities. Please do not list all association programs.

  1. Membership Growth and Retention(If the local’s membership is at least 90% of potential, the local should focus on how the grant will assist in retaining and inspiring members to become more active): Click here to enter text.
  1. Description of enhanced Program Goal, Objective, and Activity: Click here to enter text.
  2. Objective of the Released Time President: Click here to enter text.
  1. Member Engagement and Participation: Click here to enter text.
  1. Description of enhanced Program Goal, Objective, and Activity: Click here to enter text.
  2. Objective of the Released Time President: Click here to enter text.
  1. Building Community Relationships: Click here to enter text.
  1. Description of enhanced Program Goal, Objective, and Activity: Click here to enter text.
  2. Objective of the Released Time President: Click here to enter text.
  1. Developing Interaction and Cooperation between Local and State: Click here to enter text.
  1. Description of enhanced Program Goal, Objective, and Activity: Click here to enter text.
  2. Objective of the Released Time President: Click here to enter text.

Please provide a detailed budgetClick here to enter text.
(You may skip this entry if you plan to upload a separate spreadsheet when you upload your application template)

REQUIRED SIGNATURES

Please print the following statement page. Include the required signatures from the necessary state and local officials with the rest of your application to be uploaded online.

It is understood and agreed, as evidenced by the affixed signatures, that signature indicates approval and/or agreement with the submission of the application:

1. Payment of the State Affiliate share of the funding;

2. Required attendance of the local president and UniServ director/staff at the first-year training;

3. Required submission of the yearly program evaluation.

Click here to enter text. / Click here to enter text. / Click here to enter text. /
Local President / Local Association Treasurer / UniServ Director/Staff
Click here to enter text. / Click here to enter text. /
State President / State Executive Director