THE COMMUNITY FOUNDATION OF GREENE COUNTY

CONSOL ENERGY EXECLLENCE IN EDUCATION (CE EIE) FUND

GRANT APPLICATION FORM

The CONSOL Energy Excellence in Education Fund offers grants for programs that enhance educational opportunities for students in Greene County, Pennsylvania public schoolsthrough the purchase of special project supplies, equipment and other items to assist the educational process, as well as professional development opportunities for teachers in order to enhance student learning and performance. Applicants must be teachers or administrators of public schools/districts in Greene County. Requests from other organizations or other individuals will not be considered.

Classroom grant proposals of up to $500 will be considered.

The application should be completed, then printed and signed by the school principal or the district superintendent. Deliver the original application to the CONSOL Energy Excellence in Education Fund, c/o CFGC, 108 E. High Street, PO Box 768, Waynesburg, PA 15370. Applications must be received no later than 4 p.m. on the 15th of February, April, June, August, October, or December each year.

Name of School:

Address:

Contact Person for Project : Title:

Phone: Fax: E-mail:

Project Title:

Amount of Grant Requested: Total Project Cost:

When are funds needed? Project Begin & End Dates:

Is this a □ New or □ Continuing project? If continuing, when did it start?

Who will directly benefit (such as number of students, grade level(s), course of study, etc.)

Provide a clear explanation of the project. Be specific about planned activities.

What is the expected educational benefit to the students and how will you measure success?

On a separate sheet of paper, present a line item budget including all project expenses and all income sources.

Identify how funds requested from the CE EIE Fund will be spent if requesting partial funding.

How will you publicly acknowledge CE EIE if you receive a grant award?

The authorized undersigned hereby certifies that:

1) All information contained in and submitted with this proposal is correct and submitted with the approval of the Superintendent of Schools;

2) This Organization does not support or engage in any terrorist activity, and;

3) If a grant is awarded to this Organization, the proceeds of that grant will not be distributed to or used to benefit any organization or individual supporting or engaged in terrorism, or used in any other unlawful purpose.

Signature- Building Principal or District SuperintendentPrint Name

Title: Today's Date:

CFGC CEEIE Application August 2013