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Please note: You must already have submitted a preliminary proposal and been notified that it has been accepted before submitting this form.
   
First Name:
Last Name:
Email Address:
Home Address:
City:
State:
Zip:
Phone Number:
  (example: 407-123-1234)
   
School/Office Address:
School/Office City:
School/Office State:
School/Office Zip:
School/Office Phone:
  (example: 407-123-1234)
 
Catagory of Funds Requested:
Training Mini Grant Scholarship
Public Awareness of Value of Social Studies
   

Purpose of the Activity : Please elaborate; including title, goals, intended audience, activities and evaluation. (Please check your district policy to ensure this project conforms to all requirements.)

How will the activity or what is learned be shared with your school and/or community?:
   
I agree to submit an article about my activity or what I have learned to “Trends and Issues” and/or conduct a session at the next FCSS Conference:
Yes No
   

Specifically list ALL costs:

Example
Item: $50.00, Item2: $100.00, Item3: $400.00, etc...
  Total: $
   
I am receiving additional funding:
Yes No (matching funds may be required)
   
Would you be willing to accept partial funding?:
Yes No
   
If approved, monies will be dispersed by a designated agent. i.e.: school bookkeeper, district office. List the specific office/agency that will receive and distribute funds.
Name:
Address:
City:
State:
Zip:
Phone Number:
  (example: 407-123-1234)
   

Timeline: Please identify a timeline for significant events and distribution of funds for this project.
   
Note: Applications are considered on an ongoing basis, but may take up to four weeks to process.
   
Is Your Supervisor Aware of the Intent of This Project? Yes No
Supevisor's Name
   
 
Leave this field empty
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Wednesday: 9/ 8/ 2010
Florida Social Studies

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