To return to this application page, bookmark: http://www.cybergrants.

com/dollar_general/youth_literacy
The organization you are currently associated with is Northside High School. If you work with multiple organizations, click here to add a new organization to your account.

Dollar Generals commitment to literacy began with J.L. Turner, co-founder of Dollar General. With only a third grade education, J.L. was able to overcome tremendous odds and launch a successful retail business. As an extension of Dollar Generals corporate commitment to literacy, the Dollar General Literacy Foundation was established in 1993 to help increase the functional literacy of adults, families and children.

Funding Focus
Dollar General Literacy Foundation Youth Literacy Grants provide funding to schools and local nonprofit organizations to help with the implementation or expansion of literacy programs. Programs must target K-12th grade students who are new readers, below grade level readers and readers with learning disabilities. Organizations requesting funds must provide direct services to one of the groups of readers defined above, and instruction must be designed to meet the varying learning preferences and needs of the defined target population.

Grant Maximum: $4,000

Youth Literacy grants provide funding for instructional materials, books, computers and software. Administrative fees, salaries and stipends are not supported through this grant.

Timeline:
May 23, 2013 August 21, 2013 May 22, 2014 Deadline to apply Grants announced Impact reports due

Reporting Requirements:
Organizations receiving funds from the Dollar General Literacy Foundation are required to provide an impact report detailing the progress that has been made toward the objectives outlined in the approved proposal. Organizations will be required to report the number of students served, student education gains, and detailed budget information. Organizations that do not comply with reporting requirements will not be eligible for future funding from the Dollar General Literacy Foundation. You will receive an e-mail notification once your Youth Literacy impact report is available for completion online.

Questions regarding our charitable practices?

Contact the Dollar General Literacy Foundation at (615) 855-5201.

Questions regarding technical support or assistance for the on-line application?

If you have technical questions regarding this application, use the link located at the bottom of every page to contact our support team.

Application Preview
We recommend that you familiarize yourself with the online application before you begin by clicking here.

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The online grant application consists of eight main sections, each of which must be completed for your proposal to be considered. Contact information pertaining to your organization. Organization information. Overview of the proposal your organization is submitting for approval. Project Purpose and Outcomes. Project Design and Evaluation. Budget Information. USA Patriot Act Counter-terrorism Compliance. Approval of Board Chair, Executive Officer, or Principal. Once completed, all applications created online are immediately submitted to Dollar General Literacy Foundation.

To Start Your Application:

To create a new application, click the "Start a New Application" link at the bottom of this page.

You may also save your applications now and return to work on them later. To continue work on an unsubmitted application, log in at the URL below and click the "Continue" link next to the application's Project Title. You may wish to bookmark this link for future reference.

http://www.cybergrants.com/dollar_general/youth_literacy

Please be sure to save your password to your online application as it will be needed to complete your final report.

Printing Your Completed Application

The best way to view your application and print is on the 'Review Your Application' page.

1. Complete all required fields on the application. 2. Click the "Save and Proceed" button on the last section to bring yourself to the 'Review Your Application' page. 3. Go to 'File' and then 'Print' on your browser toolbar. Please note: You may need to change the orientation of your page setup from Portrait to Landscape.
To view an application previously submitted to Dollar General Literacy Foundation, click the "View" link next to the appropriate Project Title.

Each page will have a timeline like the one below to help you monitor your progress. The line and text will indicate your current position within the application process.

*First Name Steven *Last Name Hornyak *Title Teacher *Address 926 GREEN ST *City WARNER ROBINS *State Georgia *Zip 31093 2742 Telephone Fax E-mail Address
Organization Information

*Legal Name Northside High School AKA Name *Address 926 GREEN ST

*City WARNER ROBINS *State Georgia *Zip 31093 2742 County Houston Telephone Fax *Nearest Dollar General Store 2 IRS 501(c)3 Determination Letter *How long has your organization been in 50 existence? *Type of School Public *Ages of Youth Served Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade *Principal Services Secondary education to children in Warner Robins, GA
Overview

*Project Title Top Flight *Requested Cash Amount $4,000.00 *Number of individuals to be served by 112 funding from this Youth Literacy application *Projected Ethnicity Served 44.00 African American 5.00 Asian/Pacific Islander 39.00 Caucasian 13.00 Hispanic 11.00 Multi-Racial 112.00 Total *Program or Project Target Audience Below Grade Level Readers *Please select the category that best Helping individuals build a strong literacy and basic describes the purpose of this initiative: education foundation *Have you received previous funding from No the Dollar General Literacy Foundation?

If Yes, what was the grant amount and when did you receive it? *Is this the first year of the project that you Yes are requesting funding for? If it is not the first year for this project, then how many individuals were served by this Youth Literacy project last year? *Board Members Sonya Peterman Greg Peavy Amanda Coker Steven Hornyak
Project Purpose and Outcomes

*Where is the specific geographical area to Northside High School serves an area of Houston be served? County that is plagued with poverty. Sixty four percent of the population of our school is considered economically disadvantaged. *What is the unemployment rate? The unemployment rate in the local community surrounding Northside High School approaches 14%. There are many residents who have lost their jobs in the last year and some who are underemployed. *What is the high school graduation rate? The graduation rate at Northside High School is 65%. *What is the drop-out rate? The drop out rate is currently 23% yet has been decreasing over the past five years. *What is the poverty level in the The poverty level in the community surrounding geographical area served? Northside High School is relatively high. Approximately 64% of the students at Northside High School are considered economically disadvantaged. *If you are a school, what is the 43 free/reduced lunch rate? *Project/Program Purpose The purpose of Top Flight is to encourage students that are currently below grade level to enjoy reading through various activities. These activities include: in school reading incentive programs
Project Design and Evaluation

*Project/Program Design Top Flight is designed to assist students in developing a foundation in reading. Reading is fundamental and Top Flight helps students who are currently below grade level reading achieve mastery of reading through three primary programs. The first program is a reading incentive program that is administered by the school library. Students check out books and read them and receive prizes after taking tests showing that they read and understood the books. The second program is a book club started by one of the English teachers at Northside. The third

program is an after school reading program that encourages reading for pleasure. *Timeline The project is expected to run through the end of the current school year, May 24, 2013. The program is designed to be implemented every school year with students participating in both semesters. *Measurable Results 50 students will increase their reading comprehension by at least one grade level. *Assessment Methods Each student entering the program will take the National Right to Read Foundation Reading Competency Test before beginning the program. Twice throughout the semester students will take the assessment again to check their progress, once in the middle of the program, and one at the end of the semester. *Available Technology The Northside High School Media Center currently has 34 internet connected computers ready for students use as well as one mobile laptop lab that will be used for the program. *Computers and Software Northside High School currently has 64 computers available for the use of the reading program.
Budget Information

*Budget Allocations $1,000.00 IM - DGLF Request $2,000.00 BO - DGLF Request $1,000.00 SO - DGLF Request $4,000.00 Total *Budget Narrative Instructional materials will be purchased in order to provide the foundation for the program. Students will interact with program administrators as well as their peers with these instructional materials to increase reading for pleasure among program participants. Books take up the bulk of the budget as they are what students will be using throughout the program. Software programs that track progress and allow students to search for books will be used extensively throughout the program. *Audited Financial Statement Doc2.docx (12.29 K, uploaded by Steven Hornyak on
03/08/2013) USA Patriot Act Counter-terrorism Compliance

*AGENCY/ORGANIZATION NAME: Northside High School Check the appropriate box to indicate your compliance with each of the following:

*Patriot Act - Question 1 Agree *Patriot Act - Question 2 Agree *Patriot Act - Question 3 Agree *Patriot Act - Question 4 Agree *Patriot Act - Question 5 Agree *Patriot Act - Question 6 Agree *I certify on behalf of the organization listed above that the foregoing is true. I Agree
Approval of Board Chair, Executive Officer, or Principal

*Name of Board Chair, Executive Officer, or Greg Peavy Principal *Title of Approving Officer Principal *I understand that all mailed I Agree correspondence, including payment of an awarded grant proposal, will be sent to the organizations address provided in the Organization Information section of this application. *I understand if this proposal is selected for I Agree funding and the grant check is not cashed within ninety days of receipt of funding, the check will be null and void and the grant will be forfeited. *Submission Approval I Agree