AREA EDUCATION GRANTS

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					                                        AREA EDUCATION GRANTS
                        (a fund of the Foundation for the Tri-State Community, Inc.)

(For Office Use Only)                                           Project Number               ____________________
Amount of Funds Approved ____________________                   Month to Visit               ____________________
Date Application Received ____________________                  Date Funds Requested         ____________________
Contract Letter Received  ____________________                  Final Report Received        ____________________
                                            Mini-Grant Application
                                          $500 Maximum Grant Award

                                        Deadline: Friday, Feb. 13, 2009
                            Area Education Grants, PO Box 2096, Ashland, KY 41105

Grants can be used for any grade level, 2009-10 School Year. Grants that are innovative and
outside the regular classroom curriculum will be given priority. Funds will be granted upon request.
You will be notified by a board member. Recipients MAY NOT deduct grant funds as a non-reimbursed
classroom expense on the recipient’s personal income tax return.

Funding cannot be used for classroom equipment not directly related to the project, transportation,
or teacher stipends.
Date



Applicant’s Name and Contact Person                                   Co-Applicant, if any, fill in here


Home Address, Street, City, State, Zip                                Home Address, Street, City, State, Zip


Home Phone                                                            Home Phone


E-mail                                                                E-mail


Position or Grade(s) taught                                           Position or Grade(s) taught



           Name of School                             School Phone                             School District


                                                     School Address


  Please list below any teachers, other than applicant (and co-applicant), who are participating in the project.


                                     Name, Address, Position or Grade(s) taught


                                     Name, Address, Position or Grade(s) taught

                            All applicants must be actively involved in executing the grant.
                                         (Do Not Write on Back of Application)
                                                Project Number
                                      _______________________________
                                           (For Office Use Only)


Please TYPE OR USE BLACK INK when filling out the application. Inks of other colors do not always copy
clearly. Please DUPLICATE the completed application and retain the copy for your file.


1.   Title and a one-paragraph description of the project.




2.   Total Cost of the Project:

     Amount Requested from Area Education Grants: ($500 Maximum)

     Funding Source of Balance (if applicable)
                                             Project Number
                                   _______________________________
                                        (For Office Use Only)

3.   A. What is the goal of the project?
     B. Why do you think there is a need for it?
     C. How will students benefit from participating in this project?
     Be as specific as possible and clearly state your expected outcomes.
                                                 Project Number
                                       _______________________________
                                            (For Office Use Only)


4.   Describe your project. Include materials you will need and the methods you will use.




5.   What grade(s) will this project benefit?
                                                 Project Number
                                       _______________________________
                                            (For Office Use Only)

6.   Give a time schedule of events.




7.   Approximately how many students will be participating in this project?

8.   Will this project be ongoing, continuing to be implemented in future years?   YES   NO

9.   How will you measure your project’s success?
                                                           Project Number
                                                 _______________________________
                                                      (For Office Use Only)


10. List in detail the amount of expenditures requested from Area Education Grants.
          If filling out the application electronically, double-click the box below to add information. Amount will automatically tabulate.

                                                         ITEM                                                                     AMOUNT
   1

   2

   3

   4

   5

   6

   7

   8

   9

  10
                                                       TOTAL                                                               $                   -

Complete and return the attached Final Financial Report as soon as the project is completed. The
maximum amount of this grant is $500.


11. We MUST have a one to two sentence summation of the grant. This information will be used for publicity
    and for our annual report.




12. What month would you like AEG committee members to visit/observe your grant?



Projects should be completed by April 30. Board approval MUST BE obtained for any date after this.

Each grant recipient MUST PARTICIPATE in the AEG Mall Exhibit in May 2010 to remain eligible for
future grants. By submitting this application, the applicant AGREES that Area Education Grants may
share the information contained in this application. When discussing the project with the news media,
mention that it was funded in whole or in part by Area Education Grants.

Area Education Grants was established in 1983 to serve all accredited schools, both public and private, in
Boyd and Greenup counties. The grants are awarded to individual teachers, on a competitive basis, for
implementation of innovative projects that increase learning opportunities for students.
                                             Project Number
                                   _______________________________
                                        (For Office Use Only)
                                                                              Project Number ______



                                 Area Education Grants
                            Mini-Grant Final Financial Report

Amount allocated by Area Education Grants

Instructions:

   1. Itemize expenditures on the project at the bottom of this page. (Use additional pages if
      necessary.)

   2. Attach receipts or copies or receipts.

   3. List the amount of any surplus funds and return them with this report (if applicable). The
      surplus funds and total of receipts should equal the amount of the allocation from Area
      Education Grants.

   4. You may write your evaluation on the back of this report if you choose to do so.

   5. This report should be sent to Area Education Grants along with your evaluation of your project.
      As soon as the project is completed, the report is to be signed and returned by the
      teacher.

      Mail the report to:                Area Education Grants
                                         PO Box 2096
                                         Ashland, KY 41105-02096


      Total of itemized expenditures           $_______
      Total of surplus, if applicable.         $_______
      These two numbers should equal           $_______

      EACH GRANT RECIPIENT IS REQUIRED TO PARTICIPATE IN THE MALL EXHIBIT IN
      MAY 2007 TO REMAIN ELIGIBLE FOR FUTURE GRANTS.



      Teacher’s Signature _____________________________________
                         (First)             (Last)