Cultural Expeditions Grant Program Application

2016-2017 School Year

Name of School or Cultural Organization submitting this application: ______

PART I: CULTURAL ORGANIZATION INFORMATION

Cultural Organization:

Project Contact:Title:

Email: Phone:

Address:

City, State Zip:

What year(s) has Cultural Organization been a member or grantee of the Cultural Council:

How many CEdC Meetings has a representative of the Cultural Organization attended in the past 3 years:

List the names of the educational programs that have been approved by the Palm Beach County School District in the space provided:

What is the organization’s current field trip budget?

How would this grant help to fulfill the organization’s goals?

List any Cultural Expeditions Grants already received by the Cultural Organization in the current school year:

PART II: SCHOOL INFORMATION

Public School:

School Contact:Title:

Email: Phone:

Address:

City, State Zip:

Percentage of students eligible for free/reduced lunch:

Distance from the cultural organization to the school in miles:

Briefly describe the history of the partnership between this school and the Cultural Organization in the space provided:

NOTE: A commitment letter from the school’s Principal and the Cultural Organization’s Executive Director, or equivalent,is required.

PART III: CULTURAL EXPEDITION PROPOSAL

Project Title:

Project Description:

Who Will Benefit:

List Grades: Number of Classrooms:

Number of Teachers: Number of Students:

What are the educational goals of this Cultural Expedition?

What curriculum standards will be met?

What are the Project’s Intended Outcomes?

Project Evaluation: What are the measurement indicators you will use to determine if the intended goals were met?

Proposed dates of Cultural Expedition: 1.2. 3.

PART IV:REQUEST AMOUNT AND BUDGET DETAIL

Grant request amount: $

Estimated cost of bus rented from Palm Beach County School District: $

Estimated cost of charter bus rented from private company: $

List name of bus company providing the estimate:

Price of Admission per student charged to the project: $

Price of Admission per adult charged to the project:$

Do the prices of admission include a discount rate? YES: NO:

Grant Request / Matching Funds / Total Program Cost / Notes
Transportation / $ / $ / $
Admission Fees / $ / $ / $
Other expenses / $ / $
TOTAL / $ / $ / $

PART V REQUIRED DOCUMENTS AND INFORMATION

Please attach the following documents to your completed application

  1. Cultural Organization’s IRS Tax Determination Letter
  2. Commitment Lettersigned by school’s Principal confirming the partnership
  3. Commitment Letter signed by Cultural Organization’s Executive Director or equivalent

1September 2016