21st Century Enrichment Grant Application To download and print this form rather than completing it online, please click here. Should you choose to download and complete this form rather than submitting it online, please email yourcompleted form to Emily Gordon, Executive Director of HotSpots Extended Care Programs at firstname.lastname@example.org.School Population CriteriaElementary SchoolAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country School CapacityTotal Number of ClassroomsName of Principal/SupervisorEmail Address of Principal/Supervisor School Liaison InformationSchool Liaison or Committee Chair Email Address of School Liaison Individuals Represented on the Committee and Their PositionAs the School Liaison, identify three (3) leadership goals that you will achieve through this collaborative grant process. Directions: Respond clearly and specifically to each of the statements/questions below. I. Define the Need (30 points: 10 points per question)Describe the nature and extent of the need, using data that is current and rele- vant to your school (ex: School Progress Plan or Academic Data).Describe the relevance of the identified 21st Century Theme to the school need.Describe how this grant will address the identified needs.II. Explanation of Grant GoalsWhat are three clearly defined, obtainable educational and collaborative outcomes that are measurable? (10 Points)The 21st Century Enrichment Grant Initiatives goals are outlined below. Please describe how each goal can be measured through the implementation of the grant, at your school. (20 Points)Goal I. Serve more children and school communities in BCPS with high quality hands-on collaborative events.Goal II. Maximize the impact of school community events through collaborative strategic planning and as a result diversify resourcesGoal III. Offer capacity building opportunities to community partners so they may better serve their educational communityGoal IV. Offer schools an opportunity to extend the grant efforts into sustainable long-term projectsIII. Explanation of Community Collaboration and Sustainability Efforts (20 points:10 per question)Identify specific actions that will be taken to increase involvement and attendance at the event (consider student, parent, teacher and community participation, as well as, modes of marketing and recruitment).Provide an explanation of the ongoing sustainable efforts that will be taken to increase the impact of this one-time event.IV. Explanation and Evidence of Effective Execution (30 points: 5 points per question)Describe a successful past collaborative event.Address the following information in your explanation: 1. Identify specific actions that made your event a success. 2. Estimate the number of people in attendance (specify students, parents, teachers and community partners as appropriate). 3. Identify marketing efforts taken to educate the school community. 4. Identify community partners or local organizations and their level of involvement/contribution to the event.Provide a plan of action including a chronological timeline for strategic initiatives and key actions in the preparation and implementation of the grant.Outline a detailed budget, including specific information on materials, equipment, services and any other fees, charges and/or payments.Section II: Application Budget AttachmentsBudget Sheet**Please use the budget template. Once completed, please upload your budget template before submitting. Accepted file types: doc, xlsx, pdf.Please have your Administrator complete an Administration Letter of Support with the following ideas included. 1. Administrator's Name 2. Preferred Method of Contact: Phone or Email? 3. Administrator's Phone Number 4. Administrator's Email Address 5. School Address 6. School Liaison Referral: Briefly describe the grant applicant, School Liaison's leadership qualities. 7. Grant Need: In five sentences or less, identify the school/community need that this grant would support and describe how this grant would add value to your community. 8. An approval of the school’s commitment and an acknowledgement that they accept the School Liaison’s responsibilities, if your school is chosen as a grant recipient. Please state that the School Liaison will: a. Attend a mandatory Grant Orientation on November 9, 2017. b. Review The Collaborative Agreement, which outlines the school's requirements to fulfill the Grant criteria. c. School Liaison is responsible for maintaining monthly communication as outlined in The Collaborative Agreement. d. The School Liaison and the School Administrator (or a school representative) will attend the Gallery Event November 2018 (the exact date, location and time to be determined). Please have the School Administrator sign and date the letter of support.Once completed, please upload your Administrative Letter of Support before submitting.Accepted file types: pdf, doc. Initiative Summary: A project summary is due to the Education Foundation upon the conclusion of the initiative no later than Friday May 25, 2018. See the project summary for details. In addition to the project summary, a one page “Story Board” document, created on the Power Point template provided by the foundation. This “Story Board” will provide a snapshot of the impact the awarded grant has had on the school community. It will be published for future content supporting the foundation. A grant recipient who does not submit a summary will not be eligible for future funding consideration until the summary has been received.