Instructions: Please type or print. Feel free to attach illustrations, or other material necessary to best present your request.

Applicants(s): ________________________________________________________________
Contact Person(s): ____________________________________________________________
School(s): ___________________________________________________________________
Title of Project: ______________________________________________________________
Grades Involved:   K   1   2   3   4   5   6   7   8   9   10   11   12
# of Students Involved: ____________________
Total Amount of Request: $ ________________
(Provide breakdown on next page)
Project Description: Be specific and provide detail, including what you will be doing, over what period of time, what student involvement will be).

Objective/Purpose of Request: How does your request enhance your instructional skills or program? Describe how this project will enhance the uniqueness and excellence of our schools?

Upon completion, what positive effect will the project have had on your school improvement plan? What will be your measure of success?

Equipment Purchases: B/MEF expects that equipment purchased remain in the possession of the schools. What equipment or other tangible assets will be purchased: (Please provide a complete description, manufacturer, model, etc.) Also include the expected life of the equipment and its proposed frequency of use. Please list if anyone else will benefit from the purchase and what equipment this purchase will be replacing, if any.

Budget Considerations: Aside from the tangible asset purchases described above, please outline other financial needs for this proposal:

Budget: Our goal is to provide funds to implement exciting and well executed programs. Sometimes, however, funds are not available to fully fund a proposal. In that event, we may fund part of the request with the hopes that the shortfall can be found elsewhere, or the scope of the project can be limited to the available budget. If that situation arises in the case of this proposal, please indicate the minimum amount needed for you to continue this project. $ _______________.
Please describe how you would reduce the scope of your proposal to accommodate available funds, but still meet your objectives.

Is this grant request linked to other grants for which you are applying elsewhere?
Yes ____ No ____

BUDGET BREAKDOWN

$ _____________ Equipment Purchased
   _____________ Consumables Purchased
   _____________ Travel
   _____________ Expenses
   _____________ Other (provide detail)
   _____________
   _____________
$ _____________ Total requested to fully fund this project (carry total to Page 1, Total Amount of Request)