Experiential Grant Application - Telluride Education Foundation

Applicant Information

Applicant Name*

First Last

Job Title

Email*

Phone*

Project Information

Proposed Project Title*

Proposed Project Date*

Amount Requested

Please describe the intended project or program you are planning with your students:*

Please describe the expected learning outcomes for the students involved in the project:*

How/when will the success of the project be measured and who will evaluate the success?*

Do you have plans to test student's skill and/or knowledge of the subject matter prior to the project? After the project?*

Please describe how this project will involve students in experiential learning?*

Student/Class Information

# of students directly involved*

# of class sections directly involved*

# of students indirectly involved*

# of class sections indirectly involved*

# of teachers involved*

# of paraeducators involved*

# of hours of instruction provided per student for the length of the program:*

Demographic Information

# of non-Caucasian students*

#of students living outside Telluride or MV*

Expected # of participants who will demonstrate growth in knowledge*

Grade Levels*

Budget Information

Use the table below to breakdown your budget by item*

Use the + to the right to add additional rows.

Budgeted Items	School Budget	Other Funds	TEF Request

Have you used an appropriate percentage of available school funds?*

Yes
No

If yes, how much and from what source?*

Applicant has read the submission requirements of Part 2, Experiential and Classroom Grant Follow-Up and agrees to provide all information within 4 weeks of project completion. TEF requires this information to report back to our funding organizations and your timely completion of the follow up form will affect awards of future TEF grants.

Applicant Signature (type name)*

Date*

This application will be sent to your principal for approval prior to it being sent to TEF. Please select your principal from the list

Principal*

Name

This field is for validation purposes and should be left unchanged.