Individualized Learning School Intermediary Grant Program

APPLICATION QUESTIONS

Please be sure to review the grant guidelines before startingyour application. To ensure your highest level of competitiveness, we ask you to respond to all questions under each category.We also ask that you consider brevity in your responses. Please don’t exceed 10-14 pages in total application length.

Return your completed application to Yong Her, , bythe end ofWednesday, May 23, 2018.Please include “Individualized Learning School Intermediary Grant” in the subject line when you submit your application.

I. Organizational Information

Please provide the following. If you’re using a fiscal sponsorship arrangement, the fiscal sponsor is the applicant organization.

ApplicantOrganization Name: / Click or tap here to enter text. /
Organization Legal Name: / Click or tap here to enter text. /
Organization Address: / Click or tap here to enter text. /
Organization Employer Identification Number (EIN): / Click or tap here to enter text. /
Organization Website: / Click or tap here to enter text. /
Applicant Contact Name: / Click or tap here to enter text. /
Contact Title: / Click or tap here to enter text. /
Contact Address:
(if different than org address) / Click or tap here to enter text. /
Contact Phone: / Click or tap here to enter text. /
Contact Email: / Click or tap here to enter text. /

Is your organization certified by the IRS as a 501(c)(3) public charity?☐yes☐no

Is your organization a public agency/unit of government or Indian tribal government under Section 7871 of the Internal Revenue Code? ☐yes ☐no

What is your current fiscal year operating budget? (check one)

☐Up to $49,999☐$250,000 - $499,999☐$5M+

☐$50,000 - $99,999☐$500,000 - $999,999

☐$100,000 - $249,999☐$1M - $4,999,999

Sponsored Project (Organization or Group)

If you’re applying using a fiscal sponsor arrangement, provide the following information. The information below should be about the organization that is being sponsored, not the applicant. A signed fiscal sponsorship agreement is required for all applicants using a fiscal sponsor arrangement. If you are not applying using a fiscal sponsor arrangement, there’s no need to complete this section. Most organizations do not use a fiscal sponsorship arrangement.

Sponsored Project (Organization or Group Name): / Click or tap here to enter text. /
Organization Address: / Click or tap here to enter text. /
Organization Website: / Click or tap here to enter text. /
Contact Name: / Click or tap here to enter text. /
Contact Title: / Click or tap here to enter text. /
Contact Address:
(if different than org address) / Click or tap here to enter text. /
Contact Phone: / Click or tap here to enter text. /
Contact Email: / Click or tap here to enter text. /

II. Individualized Learning Approach

  1. Describe your organization’s mission, history and values.

Making Education More Relevant

  1. Describe the specific approach you take to individualizing learning in schools. In your response, share:
  2. What you call your approach
  3. Specific characteristics of the approach
  4. Whetheryour approach is centered on specific school types (e.g., district/charter/private and/or elementary/middle/high)
  5. How does your approach address each of the Foundation’s three areas of relevance (cultural relevance, instructional relevance and career relevance) as defined in the grant guidelines?

Promising or Proven Approach

  1. Tell us about your work to support schools to individualize education to date. How has your approach to individualized learning changed the ways schools are structured?
  2. How many schools have you worked with? Over what time period?
  3. How do you know your approach is working better for students? How do you track progress across multiple schools?
  1. How do you work with schools to get from where they arewhen you begin working with them to full implementation of your approach? In your response, please share:
  1. In detail, the key components/activities involved in getting a school from where they were to full implementation of the approach
  2. Approximately how long it takes from start to full implementation, including any variations and reasons for the timeline
  3. What you expect from schools in terms of readiness
  4. What you offer the schoolsin terms of readiness preparation
  1. What evidence do you have to demonstrate that you have the capability and capacity to work with schools to adopt this approach to learning?
  1. What do you anticipate will happen after this funding and term expires? How will you help ensure schools will continue on-track under a new design? (e.g., through helping them work through a new financial model)

Demand for Your Approach/Proposed Work

  1. Describe the geography and/or community that you’llwork with if awarded a grant. In your response, please include:
  1. The specific geographic area(s) in which your work will take place (check all that apply)

☐Minnesota

☐Native nation(s)sharing the same geography as Minnesota, North Dakota and South Dakota

☐North Dakota

☐South Dakota

  1. Information about the geography and/or community you will serve, including numbers of schools involved
  2. Why you are proposing to work with this particular geography and/or community
  3. The types of schools you’ll be working with
  4. Demonstration of a demand for your approach from these schools
  5. Evidence that your approach is the right match for these schools

Approach Leads to Equity

  1. What is your organization’s approach to diversity, equity and inclusion? How does this show up in yourwork with schools? (e.g., including multiple voices)
  2. How do you help infuse equitable practices in the schools you work with?
  3. How is your approach helping to narrow the achievement and/or access gap for students resulting from economic and social factors (e.g. low-income status, students of color, Native students)? How do you know?

III. References

  1. Please share three references for your work, including their name, title, organization, phone number and email address. Among these references, we ask you to include:
  1. One reference from a school that has used your approach to individualizing learning
  2. One reference from a school in the Bush Foundation region that is interested in working with you and applying your approach
  3. One additional reference of your choice

IV. Applicant’s Resource Needs and Proposed Budget

  1. Share specific information about the resources needed to undertake the work outlined in this application. In your response, include:
  1. The total amount requested from the Bush Foundation and the proposed grant term (the time to use Bush Foundation funding and implement the work outlined in this application)
  2. The total budget for the proposed work, including the Bush Foundation funding (revenue and expenses)
  3. How the requested funds will be used in working with the proposed schools
  4. Any other resources beyond Bush Foundation funds you need for your approach to work in the schoolsyou’ve described (e.g., technical expertise, buildings)
  5. Any other funding you will pursue to support the proposed work (please include specific sources in your budget)
  1. Using the budget template on the following page, or a format showing similar information, share more about the revenue and expenses involved with this work.
  2. What is your organization’s total operating budget in the last fiscal year: $ ______

(year ending ______)

School Design Budget Template
Use this budget template as a guide. You may use another format if it works better for you, but we ask that you keep the content at a highlevel and similar to the information listed below. Note: Finalists will be asked to submit the organization’s financial statements.

Revenue
What revenue is necessary to carry out the work proposed in this application and where is it coming from? Include the status of funding.

AmountStatus?

Contributions from schools: $______
Requested Bush Foundation funds: $______
Other grant funding: $______
Other major sources (specify type and amount):

Type______$______
Type______$______

Total revenue: $______

Expenses
How you will allocate your resources for this work? Example allocations might include:

Funds distributed to schools$______
Direct coaching support$______
Meeting/convenings$______
Travel $______
Other major expenses (please specify type and amount):

Type______$______
Type______$______

Total expenses: $______

Budget Narrative
Please share anything else you would like to note about your budget.

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