Teacher Mini-Grant

Record Type Name

Educator's Information

First Name

Last Name

School Email Address

Educator's Phone Number

School Information

School Name

Street Address

City

State Abbreviation

Zip Code

Principal's Name

School Phone Number

Project Information

Project Name

Grade level(s) impacted

How will your project benefit students?

Target area(s) of learning

Will your project benefit a single class or multiple classes?

Multiple or Single Class Scoring

Can the project be carried over multiple years?

Amount requested

Itemized Project Cost (Attach a Word or Excel file detailing the cost of your project. For each line item, Include 1) item name, 2) quantity, 3) approximate unit cost, 4) approximate total cost of each item, and, 5) total approximate cost to implement your project.

Date funds are needed

Other

Have you previously received a Mini-Grant

If yes, how many years ago was it awarded

Previous Year Grant Awarded Scoring

Applicant Agreements

If I receive a grant, I agree to submit an after-project report including: project results and photos of class participation. I agree that my name, project photos, and information may be used in publications and publicity of Peace River Electric Cooperative and/or its Operation Round Up Charitable Foundation without compensation.

I agree

I agree I am a certified educator in an accredited Florida Pre K-12 school in Brevard, DeSoto, Hardee, Highlands, Hillsborough, Indian River, Manatee, Osceola, Polk, or Sarasota County. My school is located in an approved zip code for the purposes of this grant. This is the only application I have submitted. I will use this grant, if awarded, for students in grades Pre K-12. By submitting this application, I acknowledge that I agree with these terms.

I agree

Applicant Signature

Date