Ed FOundation Application Form

The kearny education foundation, inc.

mini-grant proposal form

Date:__________________

Name(s):___________________________________________________________

School:_____________________________________________________________

Phone:_________________________ (work) ______________(home)__________

Grade Level(s) for Proposal:______________________________

PROJECT OVERVIEW AND GOALS: (Please connect these goals to the New Jersey Core Curriculum Standards)

Items Required: Estimated Cost:

_________________________________ _____________________

Total Funds Requested:_______________________

PLANNED OR ANTICIPATED ACTIVITIES: (attach additional sheets if necessary)

DESCRIBE THE CHANGES IN STUDENT ACHIEVEMENT YOU EXPECT:

DESCRIBE HOW YOU WILL MEASURE THESE CHANGES:

ARE YOU WILLING TO DISCUSS AND SHARE YOUR PROGRAM WITH OTHERS? Yes___________ No _____________

_____________________________________________________________________

Signature of the applicant(s)

_____________________________________________________________________

Signature of the building principal/supervisor