The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-application/

Minigrant Application Share

We are working to make this application universally compatible. If you are having difficulty filling out this form, however, we recommend that you try again on another browser or computer with newer software. State: Ezra Jack Keats Foundation Minigrant Application Please read the Minigrant Instructions before you begin. (Failure to follow the instructions will disqualify your application.) Review the application and have all your information ready to enter. There is no time limit. However, your information will NOT be saved if you close an incomplete form. Contact and Organization Information Organization Name: Type of Organization: Mailing Address:

Organization Email: Applicant Name: Job Title: Telephone: Email: Briefly describe the geographic location and composition of the population your organization serves.

About Your Program What is the name of the proposed program?

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-application/

Is this a new program? ... if no, how was it funded in the past? Describe in detail the program activities, including how the students, educators and caregivers will be participating.

How does this program go beyond the basic curriculum?

Structure of the Proposed Program Number of sessions: Length of each session: How often will sessions be held? Program Resources How many children do you expect to participate? How many caregivers? How many other participants? Has your organization received an EJK Minigrant in the past? ... if yes, for what year? Cost of Program Remember, it's about the program. Minigrants do NOT pay for: general operating costs administrative costs transportation salaries books or equipment unrelated to the specific program Please specify the materials and costs not to exceed $500: Name of Material Cost per unit

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-application/

Units needed Total

Please specify the TOTAL COST of your program: Will your program be exclusively funded by the EJK Minigrant? Letter of Commendation If you are awarded a Minigrant, to whom should the Foundation send a letter of commendation (such as your supervisor, principal, director, etc.)? Name: Job Title: Mailing Address:

Email: Agreement I understand that this project must be COMPLETELY and EXCLUSIVELY funded by the EJK Minigrant, and that no other funds will be used for the program. The Foundation will request the return of funds for failure to comply with these guidelines.

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-application/

If this proposal is accepted, I give permission for my final report to be used in publicity, articles or presentations, online and in print. My name and the name of the organization will be attached wherever the report is posted. I confirm that I belong to the organization named above and will use the funds awarded for the educational program herein described.

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