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2021 Summer Reading Camp 

Community Partnership Grant

Online Application

Primary Applicant Information

Address of Applicant Organization*

Contact Information

Authorized Representative's Name*
Authorized Representative's Address*

Note: The authorized representative is the signatory official of the organization.

Contact Person's Name*
Contact Person's Address*

Note: The contact person will receive the application submission confirmation email. Make sure the email address is entered correctly. The contact person must be the individual to contact in all matters regarding this grant application.


Financial Official's Name*

Collaborating Partners

Number of Partnering Organizations*

If you will have more than five partners, indicate total number of partners in the "Other" field.  Then provide the information in the fields provided for the top 5 partners and provide information for the additional partners in the box below.

Collaborating Partners

Program Information

Number of School Districts to Be Served*

If you will be serving more than three school districts, list the additional districts and their schools to be served in the text box at the end of this section (below school district 3).

Number of Schools to Be Served in District 1*
Indicate the total number of schools to be served in the district. If more than five, list the additional schools in the text box below.
Number of Schools to Be Served in District 2*
Indicate the total number of schools to be served in the district. If more than five, list the additional schools in the text box below.
Number of Schools to Be Served in District 3*
Indicate the total number of schools to be served in the district. If more than five, list the additional schools in the text box below.

Overall Program Information

Summer Camp Start Date*
Summer Camp End Date*
Days of Week Project Will Regularly Operate During Summer (check all that apply)*

Summer Camp Activities (check all that apply)*

Program Site Information

Number of Proposed Sites for Program*

If you will provide more than four sites, list the site names and their addresses and include the number of students to be served for each additional site in the description box provided after you complete the information for the first four sites.

Program Site Information (continued)

Proposed Site 1 Information

Site 1 Address*
Site 1 Contact*
(ex. 8:00a.m.–1:00p.m., 3:00p.m. – 6:00p.m.)

If this site is not at a school, provide distance in miles from school(s) of participating students.

Program Site Information (continued)

Proposed Site 2 Information

Site 2 Address*
Site 2 Contact*
(ex. 8:00a.m.–1:00p.m., 3:00p.m. – 6:00p.m.)

If this site is not at a school, provide distance in miles from school(s) of participating students.

Program Site Information (continued)

Proposed Site 3 Information

Site 3 Address*
Site 3 Contact*
(ex. 8:00a.m.–1:00p.m., 3:00p.m. – 6:00p.m.)

If this site is not at a school, provide distance in miles from school(s) of participating students.

Program Site Information (continued)

Proposed Site 4 Information

Site 4 Address*
Site 4 Contact*
(ex. 8:00a.m.–1:00p.m., 3:00p.m. – 6:00p.m.)

If this site is not at a school, provide distance in miles from school(s) of participating students.

Program Site Information (continued)

Funding Information

$
$

Budget Summary

Grant Funds Requested

Other Resources

Total Program Budget

Salaries (100)

$
$
$

Employee Benefits (200)

$
$
$

Purchased Services (300)

$
$
$

Supplies & Materials (400)

$
$
$

Other Objects (600)

$
$
$

__________________________

__________________________

__________________________

Total Program Costs

$
$
$

Proposal Attachments

Program Summary*
No File Chosen
File uploads may not work on some mobile devices.
Upload the Project Abstract as a single PDF document.
Proposal Narrative*
No File Chosen
File uploads may not work on some mobile devices.
Upload the Proposal Narrative as a single PDF document.
Budget Narrative*
No File Chosen
File uploads may not work on some mobile devices.
Upload the detailed Budget Narrative as an Excel document.
Appendices*
No File Chosen
File uploads may not work on some mobile devices.
Upload ALL appendices (Certification Signature Page, Request for Taxpayer Identification and Certification (if applicable), Timeline of Activities, and Memorandums of Agreement from Collaborative Partners) as a single PDF document.

Data Review and Confirmation Page

This page is not a submission confirmation.

Please review and verify the information in the following summary prior to submitting your application.  If any of the entries are incorrect, click on the "Previous" button at the bottom of each page to return to the appropriate section(s) and reenter the correct information.  If all of the entries are correct, click on the "Submit Application" button in the lower right corner of this screen.  You will receive an onscreen confirmation message that your application was successfully submitted.

Primary Applicant Information:

Name of Applicant Organization:  {$100801877 Name of Applicant Organization}     Applicant Type:  {$100801878 Applicant Type}

Address of Applicant Organization:  {$100801879 Address of Applicant Organization}

District Name (if school is applicant):  {$100801880 District Name (if school is applicant)}

Applicant Organization's DUNS Number:  {$100801881 Applicant Organization's DUNS Number}

Applicant Organization's Taxpayer ID Number:  {$100801882 Applicant Organization's TIN}

Descriptive Title of Program:  {$100801883 Descriptive Title of Project}

Contact Information:

Authorized Representative's Name:  {$100801886 Authorized Representative's Name}     Authorized Represntative's Position/Title:  {$100801887 Authorized Representative's Position/Title}

Authorized Representative's Address:  {$100801888 Authorized Representative's Address}

Authorized Representative's Phone Number:  {$100801889 Authorized Representative's Phone}     Authorized Representative's E-mail:  {$100801890 Authorized Representative's E-mail}

Contact Person's Name:  {$100801893 Contact Person's Name}     Contact Person's Position/Title:  {$100801894 Contact Person's Position/Title}

Contact Perrson's Address:   {$100801895 Contact Person's Address}

Contact Person's Phone Number:  {$100801896 Contact Person's Phone}   Contact Person's E-mail:  {$100801897 Contact Person's E-mail}

Financial Official's Name: {$100801900 Financial Director's Name}     Financial Official's Position/Title:  {$100801901 Financial Official's Position/Title}

Financial Official's Phone Number:  {$100801902 Financial Official's Phone}      Financial Official's E-mail:  {$100801903 Financial Official's E-mail}

Collaborating Partners:

Number of Partnering Applicants:  {$100801906 Number of Partnering Applicants}

Partner Organization 1 Name:  {$100801908 Partner Organization 1 Name}     Organization Type:  {$100801909 Organization 1 Type}     Role/Responsibility:  {$100801910 Organization 1 Role/Responsibility}

Partner Organization 2 Name:  {$100801911 Partner Organization 2 Name}     Organization Type:  {$100801912 Organization 2 Type}     Role/Responsibility:  {$100801913 Organization 2 Role/Responsibility}

Partner Organization 3 Name:  {$100801914 Partner Organization 3 Name}     Organization Type:  {$100801915 Organization 3 Type}     Role/Responsibility:  {$100801916 Organization 3 Role/Responsibility}

Partner Organization 4 Name:  {$100801917 Partner Organization 4 Name}     Organization Type:  {$100801918 Organization 4 Type}     Role/Responsibility:  {$100801919 Organization 4 Role/Responsibility}

Partner Organization 5 Name:  {$100801920 Partner Organization 5 Name}     Organization Type:  {$100801921 Organization 5 Type}     Role/Responsibility:  {$100801922 Organization 5 Role/Responsibility}

Names, Organization Type, and Role/Responsibility of Additional Partnering Applicants:  {$100801923 List names, organization type, and...}

Project Information:

Number of School Districts to Be Served:  {$100801926 Number of School Districts to Be Served}

School District 1 Name:  {$100801928 School District 1 Name}     Number of Schools to Be Served in District 1:  {$100801929 Number of Schools to Be Served in District 1}

School 1 Name:  {$100801930 School 1 Name}

School 2 Name:  {$100801931 School 2 Name}

School 3 Name:  {$100801932 School 3 Name}

School 4 Name:  {$100801933 School 4 Name}

School 5 Name:  {$100801934 School 5 Name}

Additional Schools to Be Served in District 1:  {$100801935 List names of additional schools to be served...}

School District 2 Name:  {$100801937 School District 2 Name}     Number of Schools to Be Served in District 2:  {$100801938 Number of Schools to Be Served in District 2}

School 1 Name:  {$100801939 School 1 Name}

School 2 Name:  {$100801940 School 2 Name}

School 3 Name:  {$100801941 School 3 Name}

School 4 Name:  {$100801942 School 4 Name}

School 5 Name:  {$100801943 School 5 Name}

Additional Schools to Be Served in District 2:  {$100801944 List names of additional schools to be served...}

School District 3 Name:  {$100801946 School District 3 Name}    Number of Schools to Be Served in District 3:  {$100801947 Number of Schools to Be Served in District 3}

School 1 Name:  {$100801948 School 1 Name}

School 2 Name:  {$100801949 School 2 Name}

School 3 Name:  {$100801950 School 3 Name}

School 4 Name:  {$100801951 School 4 Name}

School 5 Name:  {$100801952 School 5 Name}

Additional Schools to Be Served in District 3:  {$100801953 List names of additional schools to be served...}

Additional School Districts and Schools to Be Served Within Each District:  {$100801955 List the names of the additional school...}

Program Information (continued):

Total Number of Students to Be Served:  {$100801957 Total Number of Students to Be Served}     Summer Camp Start Date:  {$100801958 Summer Camp Start Date}     End Date:  {$100801959 Summer Camp End Date}

Days of Week Project Will Regularly Operate:  {$100801960 Days of Week Project Will Regularly Operate...}

Total Hours of Operation per Week:  {$100801961 Total Hours of Operation per Week}     Number of Hours per Day:  {$100801962 Number of Hours per Day}     Number of Weeks:  {$100801963 Number of Weeks}

Summer Camp Activities:  {$100801965 Summer Camp Activities (check all that apply)}

Program Site Information:

Number of Proposed Sites for Program:   {$100801967 Number of Proposed Sites for Program}

Proposed Site 1 Name: {$100801971 Site 1 Name}      Address:  {$100801972 Site 1 Address}

Site 1 Contact: {$100801973 Site 1 Contact}      Phone:  {$100801974 Phone}      E-mail:  {$100801975 E-mail}

Number of Students to Be Served at Site 1: {$100801976 Number of Students to Be Served at this Site}      Schools Attended by Students at Site 1:   {$100801977 School(s) Attended by Students at this Site}

Days and Hours of Weekly Operation: {$100801978 Days and Hours of Operation Each Week (if...}      Distance of Site from School(s):  {$100801980 Distance from School(s)}

Proposed Site 2 Name:  {$100801985 Site 2 Name}      Address:   {$100801986 Site 2 Address}

Site 2 Contact:  {$100801987 Site 2 Contact}      Phone:   {$100801988 Phone}      E-mail:   {$100801989 E-mail}

Number of Students to Be Served at Site 2:  {$100801990 Number of Students to Be Served at this Site}      Schools Attended by Students at Site 2:   {$100801991 School(s) Attended by Students at this Site}

Days and Hours of Weekly Operation:  {$100801992 Days and Hours of Operation Each Week (if...}      Distance of Site from School(s):   {$100801994 Distance from School(s)}

Proposed Site 3 Name:  {$100801999 Site 3 Name}      Address:   {$100802000 Site 3 Address}

Site 3 Contact:  {$100802001 Site 3 Contact}      Phone:   {$100802002 Phone}      E-mail:   {$100802003 E-mail}

Number of Students to Be Served at Site 3:  {$100802004 Number of Students to Be Served at this Site}      Schools Attended by Students at Site 3:   {$100802005 School(s) Attended by Students at this Site}

Days and Hours of Weekly Operation:  {$100802006 Days and Hours of Operation Each Week (if...}      Distance of Site from School(s):   {$100802008 Distance from School(s)}

Proposed Site 4 Name:  {$100802013 Site 4 Name}      Address:  {$100802014 Site 4 Address}

Site 4 Contact:  {$100802015 Site 4 Contact}      Phone:   {$100802016 Phone}      E-mail:   {$100802017 E-mail}

Number of Students to Be Served at Site 4:  {$100802018 Number of Students to Be Served at this Site}      Schools Attended by Students at Site 4:  {$100802019 School(s) Attended by Students at this Site}

Days and Hours of Weekly Operation:  {$100802020 Days and Hours of Operation Each Week (if...}     Distance of Site from School(s):  {$100802022 Distance from School(s)}

Names, Addresses, and Number of Students to Be Served at Additional Project Sites:  {$100802026 List the names, addresses, and number of...}

Funding Information:

Total Grant Funds Requested:  ${$100802029 Total Grant Funds Requested}     Total Program Costs (including all sources):  $ {$100802030 Total Program Costs (including all sources)}

Budget Summary:

Line Item

Grant Funds Requested

 

Other Sources

 

Total Program Budget

Salaries (100)

$ {$100802039 Salaries (Funds Requested)}

 

$ {$100802040 Salaries (Other Resources)}

 

$ {$100802041 Salaries (Total Project Budget)}

Employee Benefits (200)

$ {$100802043 Employee Benefits (Funds Requested)}

 

$ {$100802044 Employee Benefits (Other Resources)}

 

$ {$100802045 Employee Benefits (Total Project Budget)}

Purchased Services (300)

$ {$100802047 Purchased Services (Funds Requested)}

 

$ {$100802048 Purchased Services (Other Resources)}

 

$ {$100802049 Purchased Services (Total Project Budget)}

Supplies & Materials (400)

$ {$100802051 Supplies & Materials (Funds Requested)}

 

$ {$100802052 Supplies & Materials (Other Resources)}

 

$ {$100802053 Supplies & Materials (Total Project Budget)}

Other Objects (600)

$ {$100802055 Other Objects (Funds Requested)}

 

$ {$100802056 Other Objects (Other Resources)}

 

$ {$100802057 Other Objects (Total Project Budget)}

Total Program Costs

$ {$100802063 Total Direct Costs (Funds Requested)}

 

$ {$100802064 Total Direct Costs (Other Resources)}

 

$ {$100802065 Total Direct Costs (Total Project Budget)}

Attachments:

Program Summary:  {$100802068 Project Summary}

Proposal Narrative:  {$100802069 Proposal Narrative}

Budget Narrative:  {$100802070 Budget Narrative}

Appendices:  {$100802071 Appendices}

 

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