Requesting Teacher:

Email Address:

Requesting SLC:

Requesting School: -- Select School -- J. C. Harmon High F. L. Schlagle High Sumner Academy Washington High Wyandotte High

Phone Contact Number:

Total Amount Requested:
NOTE: SLCs can apply for up to $3,000 for the 08-09 school year.

Date Funding Required:

Describe the project activities, when and where the activities will be carried out.

Project Activities:

When and where the project activities will be carried out:

Below is the primary goal of the College & Carrer Funds. Write a brief statement describing how this proposal addresses one or more of the various aspects of this goal.

Fund Goal:To Enhance Student Support Systems to ensure "All students exiting 12th grade will be ready for college" — Supporting students vision for their future. Supporting students as they work on their College Readiness Benchmarks. Supporting students with enrichment opportunities that deepen the students' understanding of the theme of their Small Learning Community.

Specific Project Goals: (measurable goals for this proposed funded activity)

Break down requested funds by the following allowed categories. List the activities and corresponding expendatures requested in each category. Only activities that fit within the goals and the categories below will be considered. Food, awards, general equipment or supply requests are not the purpose of this fund.

Transportation Costs:
(buses/vans) e.g. 4-1/2 hour trip to KCKCC = $160.00

This project activity requires bus transportation.

# of students participating:      # of certified adults:

Arrival Date:       Pick up from school at: A.M.

Departure Date:      Return to school by: P.M.

This project activity requires van transportation. (no charge)

This project activity does not require transportation.

Registration/Entry Fees:

This project activity requires registration/entry fees.

# of student fees:      Cost of student fees:

Name & contact information for company/organization:

They will take the following forms of payment:
Purchase Order # (preferred form of payment)     Credit Card     Check

This project activity does not require registration/entry fees.

Substitute Teacher Costs: ($127.49 per sub)

This project activity requires a substitute teacher.

# of substitute teacher/s:

This project activity does not require a substitute teacher.

Misc. Costs:

Please explain:

Total Cost of Project Activity:

A .pdf version of the completed form will be emailed to you. When you receive this emailed version of the form, please do the following:

1. Print it
2. Obtain Principal Signature
3. Attach the following materials:
   1. sub request forms
   2. an invoice from the company/organization who is requesting registration/entry fees
4. Return all to Lori Hewitt, College & Career Specialist, Education Center,
   4601 State Ave., Suite 38, KCK 66102

Submitting application and documents does not guarantee approval. Approval notification will come within 48 hours of when the complete proposal was received.