How to Apply

Xenia Community Schools Foundation Grant Application

Applicant___________________________________________Position____________________________

School____________________________

Date______________________________

Project Title: ________________________________________________________________

Target Group: _______________________________________________________________

Number of Students to be served: __________

Statement of Need:

Project Description:

Objectives:

Timeline:

Evaluation Plan: (How will you determine whether your objectives have been achieved and whether your project has been successful?)

Itemized Costs:

Total Cost_______________

Applicant’s Signature___________________________________________

Date_________________________________________________________

Building Principal’s Signature__________________________________

Curriculum Supervisor’s Signature_____________________________

Grant Committee

Decision of Review Committee Approved__________ Not Approved________

Explanation:

Adjustments:

Chairperson_______________________________________________

Date____________________________

Form Updated: December 2013