The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-ap...

Ezra Jack Keats Foundation Minigrant Application Please read the Minigrant Instructions before you begin. (Failure to follow the instructions will disqualify your application.) Review the application and have all your information ready to enter. There is no time limit. However, your information will NOT be saved if you close an incomplete form. You will receive an email conrmation. PLEASE DO NOT RESEND. Fields marked with an (*) are required. Organization and Contact Information Organization Name * Type of Organization * Mailing Address * City * State * Zip Code * Organization Email * Applicant Name * Job Title * Telephone Number * Applicant Email Address *
Kingsley Elementary School

Public School
2051 Brendon Drive Atlanta Georgia 30338

Public Library

council@kingsleycharter.org Amanda Averill Student Teacher 404-550-7793 classaverill@gmail.com

Briey describe the geographic location and composition of the population your organization serves. Please limit your answer to 700 characters (approximately 100 words). *

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-ap...

Kingsley ES is located of a healthily diverse language and about 30% involvement within the

in a small suburb very close to Atlanta and consists group of students, 40% speak English as their second are considered economically disadvantaged. Parent school is slightly above average.

Has your organization received an EJK Minigrant in the past? * ... if yes, for what year? About Your Program What is the name of your proposed program? * If not funded by a Minigrant, will the program go forward? *

Yes

No

Goggles for the Future

Yes

No

....if yes, how will it be funded? Describe in detail the program activities, including how the students, educators and caregivers will be participating. Please limit your answer to 1400 characters (approximately 200 words) *
All students within the school, direction of the teachers, will googles/glasses and each 'lens' make positive change within the with the help of parent volunteers, and the use materials to construct a large pair of they will draw a picture of ways they can community.

How does this program go beyond the basic curriculum? Please limit your answer to 1400 characters (approximately 200 words) *
This project encourages students to think about how their choices and actions influence others, outside of their class, school, and family. They must make a plan for positive action for change to make the community in which they live a better place for all.

Structure of the Proposed Program How many sessions will be

2

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-ap...

held? * What will the length of each session be? * How often will sessions be held? * How many children do you expect to participate? * How many caregivers? * How many other participants? * Cost of Program Remember, it's about the program. Minigrants do NOT pay for: general operating costs administrative costs transportation salaries books or equipment unrelated to the specic program Materials
White 20oz Paper Cups 25 0 Consecutive Days 1 hour

400

# of units
1 Case (500 cups)

Cost per unit

68.85

Multicolored Packs of Paper 2 Reams (1000 sheets) Glue Cardstock for band 200 gluesticks 4 Packs

28.00 .35 18

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The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-ap...

Total Cost Will your program be exclusively funded by the EJK Minigrant? * Letter of Commendation

$266.85

Yes

No

If you are awarded a Minigrant, to whom should the Foundation send a letter of commendation (such as your supervisor, principal, director, etc.)? Name: * Nan H Keel Job Title * Mailing Address * City * State * Zip Code * Email * Agreement I understand that this project must be COMPLETELY and EXCLUSIVELY funded by the EJK Minigrant, and that no other funds will be used for the program. The Foundation will request the return of funds for failure to comply with these guidelines. If this proposal is accepted, I give permission for my nal report to be used in publicity, articles or presentations, online and in print. My name and the name
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Library Media Specialist 2051 Brendon Drive Dunwoody Georgia 30338

The Ezra Jack Keats Foundation Minigrant Application

http://www.ezra-jack-keats.org/minigrant-program/minigrant-ap...

of the organization will be attached wherever the report is posted. I conrm that I belong to the organization named above and will use the funds awarded for the educational program herein described. To agree to these terms, please enter: your initials: * today's date: * Just to make sure you're human: What is Ezra Keats' middle Name? *
AA 10/30/2013 Jack Submit
2013

The Ezra Jack Keats Foundation

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