Criteria for Allocation of Funds - DMS Green School



21st Century INSTRUCTIONAL INITIATIVES GRANTS

APPLICATION GUIDELINES 2014-2015

Read carefully to fully understand guidelines and expectations.

|Award Range: |Up to $2,000 per project. The number of initiatives funded will depend upon available funds. |

|Key Criteria & |Review and award of project funds will be based on the project’s anticipated contribution to essential knowledge and skills students must |

|Eligible Projects: |have to be successful in life and employment in the 21st century, clear alignment with the BCPS Blueprint 2.0: Our Way Forward and the |

| |School Improvement Plan, clear measurable objectives, and overall impact and potential for successful implementation. The 2014-2015 |

| |projects should address at least one of the following instructional focused 21st century themes: |

| |Financial, Economic, Business and Entrepreneurial Literacy |

| |Environmental Literacy |

| |Arts & Culture with an emphasis on creative writing |

| |Science, Technology, Engineering, and Mathematics (STEM) |

| |Health Literacy |

| |Projects must be conducted and supervised by BCPS professional personnel who work directly with students, including teachers, school |

| |counselors, media specialist, nurses, etc. Projects must address an identified need that is aligned with BCPS goals for academics, |

| |strategic initiatives and key actions as stated in the BCPS Blueprint 2.0: Our Way Forward and the School Improvement Plan. Funds may not |

| |replace normal funding from tax-based sources. The proposal should describe a quantitative and/or qualitative method to evaluate the |

| |success of the project. Funds may cover travel, participation in events/activities, consulting fees, and speaker honorariums. Funds may not|

| |cover personnel or any related expenses for BCPS staff. |

|Application Deadline: |On or before October 24, 2014 by 5:00 PM |

|Notification of Recipients:|Recipients will receive an e-mail notification from the director on November 14, 2014 and a media release will be placed on our website |

| |() on November 24, 2014. |

|Awarding of Funding: |Funds will be disbursed to the school/organization for project expenses according to standard Education Foundation practice as stated on |

| |the page titled Processing A Request To Disburse Funds From The Foundation Account with use of the form titled Request for Reimbursement/ |

| |Disbursement from a Foundation Project Fund. Any unexpended funds will revert to the Education Foundation unrestricted fund at the |

| |conclusion of the project. |

|Length of |Projects should be implemented during the 2014-2015 school year with all projects to be completed on or before June 5, 2015. |

|Project: | |

|Applicant Eligibility: |Applicants must be BCPS professional personnel. In the case of team-based proposals, a project coordinator must be designated to assume |

| |overall administrative responsibility for the instructional initiative grant application, submission of disbursement requests, and any |

| |other requested information or reports. Simultaneous funding of projects from the same applicant or benefitting the same classroom, |

| |department, or team will not occur. |

|Proposal Review: |Proposals will be competitively reviewed by the Programs and Allocations Committee of the Education Foundation. BCPS Curriculum and |

| |Instruction and/or Business Services professionals may be consulted as part of proposal review for the purpose of compliance and alignment.|

|Initiative Summary: |A project summary is due to the Education Foundation upon the conclusion of the initiative no later than June 30, 2015. See accompanying |

| |project summary guidelines for details. A grant recipient who does not submit a summary will not be eligible for future funding |

| |consideration until the summary has been received. |

21st Century INSTRUCTIONAL INITIATIVES GRANTS

APPLICATION COVER SHEET 2014-2015 *

| |

|Name of Principal or Supervisor : Mr Seth Barish E-mail address: sbarish@ |

| |

|School/Office: Dundalk Middle School Phone: 410-887-7018 |

| |

|Name of Applicant/Project Coordinator: Ken Compher E-mail address: kcompher@ |

|(Must be BCPS professional personnel) |

| |

|Is this a team proposal? No x Yes (If yes, list team members) |

|Ken Compher |

|Jeff Merlette |

|Sara Mullin |

| |

| |

|Title of Proposed Project: Trout in the Classroom |

| |

|Core Subject(s): (May check more than one) |

|English, Reading and Language Arts History and Culture Studies Government and Civics Arts |

|Mathematics and Economics x Science and Geography World Languages, Early Grades through Grade 12 |

|Project aligns with the BCPS Blueprint 2.0: Our Way Forward and School Improvement Plan and addresses the following instructional focused 21st century theme(s): |

|(May check more than one) |

|Financial, Economic, Business and Entrepreneurial Literacy |

|X Environmental Literacy |

|Arts & Culture |

|X Science, Technology, Engineering, and Mathematics (STEM) |

|Health Literacy |

|Anticipated Date of Implementation: January 2015 |

| |

|Anticipated Date of Completion: May 2015 |

| |

|Total funds required for project (May include funds from other sources): $1,941.63 |

| |

|Total funds requested from The Education Foundation of BCPS, Inc. for project: $800.00 |

*NOTE: Application must be completed and submitted electronically. This cover sheet will not be included as part of the actual selection process by the Programs and Allocations Committee. Consideration of your request will be based entirely on the following proposal.

21st Century INSTRUCTIONAL INITIATIVES GRANTS

APPLICATION PROJECT DESCRIPTION 2014-2015

DIRECTIONS: Respond clearly and specifically to each of the statements/questions below, limiting to a maximum of two (2) typed pages. Do not include the name of your school, administrator and/or teacher in this application project description.

| |

|Title of Proposed Project: Trout in the Classroom Grade Level 6 & 8th GT |

|Core Subject(s): (May check more than one) |

|English, Reading and Language Arts History and Culture Studies Government and Civics Arts |

|X Mathematics and Economics X Science and Geography World Languages, Early Grades through Grade 12 |

|Project aligns with the BCPS Blueprint 2.0: Our Way Forward and School Improvement Plan and addresses the following instructional focused 21st century theme(s): |

|(May check more than one) |

|Financial, Economic, Business and Entrepreneurial Literacy |

|X Environmental Literacy |

|Arts & Culture |

|X Science, Technology, Engineering, and Mathematics (STEM) |

|Health Literacy |

| |

|Implementation Date: January 2015 Evaluation Date: May 2015 |

|Total Amount of Request: 1,941.63 Date of Proposal: 10/21/2014 |

Briefly describe this project and how it will address at least one of the instructional focused 21st century themes. (10 points)

We wish to instill and foster a better understanding and appreciation for environmental conservation in our sixth grade standard science students and 8th grade GT science students by having them raise trout in our classroom and releasing them at the end of the year. We wish to educate our students on why it is important to protect and conserve our local streams and teach them strategies that they can use to help promote healthy conditions within their community.

Prior to the experience, a school wide Character Education lesson regarding overfishing and water pollution due to overdevelopment of suburban areas was delivered. Students analyzed the issue, developed research questions, and designed strategies to conduct research and data collection on local waterways.

By the end of this experience, Students will be able to:

• Successfully design & maintain the aquarium in order to provide a healthy environment for the trout as well as feeding and caring for the hatchlings.

• Utilize digital resources to observe, collect, and communicate data acquired through a four month investigation

• Participate in a variety of activities such as stenciling storm drains, completing research projects, completing a local stream study, and researching and announcing helpful tips on the morning announcements in order to promote healthy conditions for trout in our local streams.

Explain how this project meets the goals for academics as stated in the BCPS Blueprint 2.0: Our Way Forward and your School Improvement Plan? (15 points)

In BCPS Blueprint 2.0, Goal 1 Component C states:

Ensure a learner-centered, personalized, blended environment powered by digital learning and interactive curriculum access that is flexible anytime and anywhere.

This experience will be learner-centered as the students will record observational data regarding the growth progress of our trout and report the details back to the DNR. The students will record and maintain their own personal data, which we will compile and communicate digitally to other science classes in the BCPS district for use during the life sciences components of the curriculum at their discretion. This experience will be blended in the sense that the target students will be from multiple grade levels and the investigation will blend together digital, classroom, and in-the-field components.

What are the clearly defined, obtainable educational outcomes that are measurable of this project and what are the needs it will meet? (20 points)

The school-wide Character Education lesson satisfies several Maryland Environmental Literacy Standards including:

Standard 1, Topic A – Environmental Issue Investigation - The entire student body investigated and analyzed environmental issues ranging from local to global perspectives, including the impact of agriculture and overdevelopment on local waterways. We gave students several ideas on local action projects they could undertake which would protect, sustain or enhance the natural environment. After an informal polling, most chose raising trout in the classroom.

Standard 5, Topic B – Human Impact on Natural Resources – The entirety of the student body conducted multimedia –supported, whole class discussions, from local to global levels, regarding the relationship between human activities and the earth’s resources.

It is our intention to incorporate the Trout in the Classroom initiative in the fulfillment of additional Maryland Environmental Literacy Standards, including:

Standard 1, Topic B – Environmental Issue Action Component- all sixth grade and 8th grade GT Environmental students will develop and implement an environmental action plan regarding the environmental benefits of raising and releasing trout. They will communicate, evaluate and justify personal views on the environmental issues of sustainable agriculture, overdevelopment, and water pollution and alternate ways to address them. Upon completion of the experience, students will analyze the effectiveness of the action plan in terms of achieving the desired outcomes. This will including data collection, graphing, and other mathematical practices.

Standard 4, Topic B – Population Dynamics – prior to implementation of the equipment, students will analyze the growth and decline of local trout populations and identify a variety of responsible factors.

Standard 4, Topic C – Community & Ecosystem Dynamics – Students use multimedia resources to investigate local stream ecology and the trout’s role there within in order to explain how the interrelationships and interdependencies of organisms and populations contribute to the dynamics of communities and ecosystems. Selected students will then accompany the BCPS professional personnel associated with the project to an off-campus site to release the trout and conduct a water quality survey.

Standard 6, Topic B – Human – Induced Changes & Human Health – After the invesitgation, students will analyze, from local to global levels, the relationship between human activities and the earth’s resources.

Standard 7, Topic B- Independent & Group Actions & the Environment – After the investigation, the students selected to attend the off-campus release / water quality survey will share their observations and collected data with the remainder of the student body in order to examine the influence of individual and group actions on the environment and explain how groups and individuals can work to promote and balance interests.

Identify and explain the research based instructional methods/techniques and skills that will be implemented through this project. (Learning and Innovation Skills, Information, Media and Technology skills and/or Life and Career Skills). Be specific. (20 points)

Several techniques and skills will be realized and augmented throughout the project’s duration. The students will collaboratively design a trout habitat prior to their arrival, collectively troubleshoot any setbacks during the raising, and collaborate to communicate their findings and create a environmental action component of their own for future classes. This addresses Learning and Innovation Skills, which place a focus on creativity, critical thinking, communication and collaboration.

The project also has a heavy focus on using multimedia resources in order to research and communicate with a large audience about information gathered. Students will use Google Earth to view topographical maps, various websites to research trout populations and will report their findings to the Conservation Success Index, which reports data from around the world about various species of plants and animals. This project will thereby focus on Information, Media, & Technology Skills as students must demonstrate a range of functional and critical thinking skills related to information, media and technology.

The students will also engage in Life and Career Skills consistently throughout the project. In order to be successful, they must work appropriately and productively with one another to design a habitat, share rigorous workloads, and develop action components from newly acquired knowledge and insight. They will need to demonstrate synergistic qualities by pooling the collective intelligence and experience of the group in order to meet the various goals and checkpoints. Additionally, the level of responsibility to the fish in the tank, the other stakeholders relying on their data, future classes, and the environment as a whole will be constantly reinforced throughout the experience.

What grade level(s) and core subject area(s) will be addressed by this project? Approximately how many students will benefit? What is the potential impact on students and is there a possibility for expansion of this project to other grade levels and/or schools? (10 points)

This project will include the entirety of the 6th grade standard science classes (164 students) and the entirety of the 8th grade GT environmental science class (32 students). The project will allow students the opportunity to conduct a hands-on investigation into the role an organism plays within an ecosystem, the skills and processes necessary to conduct a proper scientific investigation, the importance of collecting, recording, and communicating data with others within the scientific community. Additionally, the students will reinforce math skills by calculating averages, maintaining time lines, and graphing data points. Furthermore, this project will thoroughly satisfy multiple Maryland Environmental Literacy standards for approximately one third of the DMS student population. Students selected to attend the trout release excursion will experience first- hand the impact that humans have on local stream ecology and report their findings to their peers upon their return from the field.

This project is very easily expanded upon on several levels. Trout in the Classroom is a national programs sponsored locally by the Department of Natural Resources. Selection for becoming a host site is competitive, but data collected can readily be communicated from students from one school to another.

List the plan of action including a chronological timeline for strategic initiatives and key actions in the preparation and implementation of this project. Include: completed lesson plan(s), communication tools and techniques for community outreach, multi-media presentations, ordering/receipting of materials, classroom implementation, evaluation tools and significant dates, etc. (5 points)

October 16, 2014 – School wide Character Education lesson about human impact on aquatic ecosystems

Late Oct – Early Nov 2014 – Obtain equipment and set up aquarium

Late Nov – Obtain trout eggs

Late Nov – Students will research trends and patterns in local trout populations and potential causes

Late Nov – May 2015 Raise trout, monitor and record water quality, chart and graph trout growth

May 2015 – Complete trout release action component, record and communicate data, and develop a repeatable, equitable action component for monitoring local waterways

Sample lesson plans recommended by the Trout in the Classroom Organization:









How will you evaluate whether the objectives for this project have been achieved? (10 points)

Success of this project will be measure by the students’ ability to design an acceptable habitat, maintain and monitor the classroom trout population. Students will be assessed on their thoroughness of data collection throughout the trout raising interval and their ability to incorporate math skills in the scientific community. Students will analyze the various components of water quality (pH, D.O., turbidity, temperature, etc) of the release point and compare this data against “ideal” conditions in order to infer about the survival probability of the trout. Students will research an audience for their data findings and communicate them to said audience. The students will also research data collected from past years about local trout population. Students will create a written or video reflection about the experience and what they have learned about human impact on local waterways. Students will collaborate to design potential projects for future classes of a repeatable, equitable nature which focus on human impact on the environment.

Note: A written project evaluation is required at the completion of the project.

Identify your detailed budget request for this project in order of priority. Include specific information on materials of instruction, equipment, services, and any other fees, charges and/or payments. If applicable, list funds/resources that will be required to implement this project beyond this grant request. Identify the anticipated source of funds for each expense. Please list Grant in the source column for expenses to be covered by receipt of this Education Foundation award. (10 points)

21st Century Instructional Initiatives Grants Project

Proposed Budget 2014-2015 **

|ITEM |DESCRIPTION |EXPENSE |SOURCE |

|Transportation |Two (2) BCPS school bus at approximately 40 |Approximately $800 |GRANT |

| |miles round trip for approximately 6 hours | | |

| |Fluval 406 canister filter |$199.99 |ARE Grant ( anticipated) |

|Tank filter | | | |

| |Foam Pre-filter |$5.96 |ARE Grant ( anticipated) |

|Tank filter | | | |

| |Fluval Biomax Media 17.63 oz |$10.19 |ARE Grant ( anticipated) |

|Tank filter | | | |

| |White Diamond NH3 Neutralizing Crystals 50 oz |$6.82 |ARE Grant ( anticipated) |

|Tank Filter | | | |

| |2-3 Chemi-Pure Charcoal 5oz |$20.64 |ARE Grant ( anticipated) |

|Tank Filter |( 3X) | | |

|Tank Filter |2-3 Pure Aquatic 300 micron 5” x 6” filter bags|$7.56 |ARE Grant ( anticipated) |

| |(3x) | | |

|Tank Filter |Whisper #40 Air Pump |$10.20 |ARE Grant ( anticipated) |

| | | | |

| | | | |

|Tank Accessories |-10” Aqua Mist add-a-stone (Penn Plax) |$ 5.14 |ARE Grant ( anticipated) |

| |-8-ft. , ¼ inch airline tubing | | |

| |-Fusion check valve 1.pk |$ 1.40 | |

| |-Battery operated Digital Thermometer |$2.41 | |

| |- Freshwater master testing kit |$7.06 | |

| |-GH & KH Hardness testing kit | | |

| |-Lee’s Squeeze Bulb Ultra gravel vacuum |$24.99 | |

| |- NovaAquaPlus Tap Water Conditioner |$5.41 | |

| |- Microbe Lift Special Blend 16oz |$20.90 | |

| |-1 Nite-Out II 16oz | | |

| |-4” Aquarium Net |$4.72 | |

| |-2bags gravel | | |

| |-Breeder Box |$10.69 | |

| | |$10.69 | |

| | |$2.37 | |

| | |$9.80 | |

| | |$15.65 | |

|Additional maintenance |1, 4’ x 8’ x 1” polyethylene insulation board |$19.47 |ARE Grant ( anticipated) |

|supplies |5 Outlet surge protector | | |

| |2, 5 gal buckets with lids | | |

| |55 gal tank and stand |$8.97 | |

| |Trade Winds DL-25 ¼ HP drop in chiller |$8.60 | |

| |Plastic turkey baster |$125.00 | |

| |Measuring spoon set |$615.00 | |

| | | | |

| | |$1.00 | |

| | |$1.00 | |

| TOTAL BUDGET ALL SOURCES |$ 1,941.63 | |

**NOTE: If this initiative is approved, copies of all invoices and proof of payments will need to be attached to a written evaluation and returned to The Education Foundation of Baltimore County Public Schools, Inc by the end of the 2014-2015 school year in which the initiative is implemented. (On or before June 30, 2015)

Send Electronically To:

Ms. Deborah Phelps, Director

dphelps@

Self Checklist for Completion of Application***

|Project is appropriate for submission if the following questions can be answered in the affirmative: | YES |NO |

|Project addresses at least one of the instructional focused 21st century themes |x | |

|Project meets the goals for academics as stated in the BCPS Blueprint 2.0: Our Way Forward/School Improvement Plan |x | |

|Project has clearly defined, attainable educational outcomes that are measurable |x | |

|Project has identified instructional methods/techniques and skills that are research based and instructionally sound |x | |

|Project has the potential to involve a large number of students with a long-term impact |x | |

|Project plan of action and timeline is clearly stated with realistic attainable dates for completion |x | |

|Project has a built in evaluation component |x | |

|Project includes a detailed budget with items and costs listed |x | |

***NOTE: See enclosed Rubric for Instructional Initiatives

PROCESSING A REQUEST TO DISBURSE FUNDS FROM

THE FOUNDATION ACCOUNT

There are two ways that funds may be disbursed from the Education Foundation. One involves the foundation paying for something directly on behalf of the school or project. The other involves the Education Foundation reimbursing the school or project for expenditures they have incurred and paid that relate directly to the Education Foundation project.

1. Directly Paid by the Education Foundation

Certain types of expenditures may be paid directly by the Education Foundation from the project funds. These include large dollar expenditures such as scholarships, technology, playgrounds, etc.

A written Request for Reimbursement/Disbursement of Project Funds form should be prepared, signed by the appropriate authorized person(s) (e.g. Principal, School Improvement Team chair, project coordinator), and forwarded with the original and one (1) copy of the invoice or order to:

Ms. Deborah Phelps, Director

The Education Foundation of Baltimore County Public Schools, Inc.

105 W. Chesapeake Avenue, Suite B-1

Towson, Maryland 21204

The Education Foundation generally disburses checks twice a month. All disbursement requests are subject to review and approval by the Education Foundation Executive Board/Full Board. All requests should take this into consideration to ensure that items will be received when needed.

2. Reimbursed to the School or Organization

Invoices or orders from schools for less than $1,000 should not be sent directly to the Education Foundation to be paid. Small invoices (less than $1,000) should be paid directly by the school (e.g. Activity Funds) or organization, and subsequently submitted to the Foundation for reimbursement monthly. To request reimbursement do the following:

a. Accumulate receipts and prepare a written Request for Reimbursement/Disbursement of Project Funds form that describes each receipt, a description of what was purchased, the amount, the vendor, the total of the reimbursement request, how it is consistent with the goals for academics/objectives of the Education Foundation project, and the Education Foundation project it applies to.

b. Forward the request, signed by the appropriate authorized person(s) (e.g. Principal, School Improvement Team chair, project coordinator), and the attached receipts to:

Ms. Deborah Phelps, Director

The Education Foundation of Baltimore County Public Schools, Inc.

105 W. Chesapeake Avenue, Suite B-1

Towson, Maryland 21204

c. Reimbursement requests will be processed by the Foundation twice each month. Accordingly, receipts should be accumulated and submitted on or about the 1st or 15th of the month.

Request for Reimbursement/Disbursement

from a Foundation Project Fund

Name of Preparer (Type) Date Phone Number Email Address

| | | | |

Name of Project School/Office

| | |

Briefly State the Reason/Purpose for the Disbursement:

| |

| |

Amount requested $      Attach original receipts, invoices, quotes, purchase orders, etc.

To be paid to (Note: A separate disbursement form must be completed and submitted for each payee):

Name of Business or School to be Paid Phone Number

| | |

Address of Business/School to be Paid

| |

| |

All requests for disbursement must be signed by at least two authorized individuals:

Name (Type) Title Signature Date

| | | | |

| | | | |

Mail to: Ms. Deborah Phelps, Director

The Education Foundation of Baltimore County Public Schools, Inc.

105 Chesapeake Ave, Suite B-1

Towson, MD 21204

(Note: Original invoice/receipts/quotes must be attached)

Rubric for 21st Century Instructional Initiatives Grants 2014-2015

|Key Criteria |4 |3 |2 |1 |Score |

|Need for Project |States a need that addresses at |States a need that somewhat |Need stated does not address at |No reference to need. |  |/10 |

|10 Points |least one of the instructional |addresses at least one of the |least one of the instructional |0 points | | |

| |focused 21st century themes. |instructional focused 21st |focused 21st century themes. | | | |

| |7-10 points |century themes. |1-2 points | | | |

| | |3-6 points | | | | |

|Explanation of How |Explanation is consistent with |Explanation is somewhat |Explanation does not address |Does not explain how goals |  |/15 |

|Project Meets Goals |goals for academics as stated in |consistent with goals for |goals for academics as stated in |for academics as stated in | | |

|15 Points |BCPS Blueprint 2.0/School |academics as stated in BCPS |BCPS Blueprint 2.0/School |BCPS Blueprint 2.0/School | | |

| |Improvement Plan. |Blueprint 2.0/School Improvement |Improvement Plan. |Improvement Plan will be met.| | |

| |11-15 points |Plan. |1-4 points |0 points | | |

| | |5-10 points | | | | |

|Major Objectives of |Objectives are clearly defined, |Objectives are defined and |Objectives are defined. |Objectives are not clear. No |  |/20 |

|the Project |attainable, and address the stated|address the stated needs. |Educational outcomes are not |measurable outcomes are | | |

|20 Points |needs. Educational outcomes are |Educational outcomes are stated. |clearly stated and cannot be |included. | | |

| |stated and are measurable. |5-12 points |measured effectively. |0 points | | |

| |13-20 points | |1-4 points | | | |

|Teaching Methods/ |Teaching methods/ techniques and |Teaching methods/ techniques and |Teaching methods/ techniques and |Teaching methods/ techniques |  |/20 |

|Techniques and Skills|skills are research-based and |skills are instructionally sound.|skills are identified. Project |and skills are not identified| | |

|to Implement Project |instructionally sound. Project |Project supports goals for |does not support goals for |and/or no goals for | | |

|20 Points |supports goals for academics, |academics, strategic initiatives |academics, strategic initiatives |academics, strategic | | |

| |strategic initiatives and key |and key actions, which may not be|and key actions. |initiatives and key actions | | |

| |actions, which are clearly stated |clearly stated and/or identified.|1-4 points |are sited. | | |

| |and identified. |5-12 points | |0 points | | |

| |13-20 points | | | | | |

|Potential Impact on |Project has the potential to |Project has the potential to |Project will only impact a few |Project does not address |  |/10 |

|Students |involve a large number of students|involve a large number of |students. |potential impact on students.| | |

|10 Points |with a long-term impact. |students with some impact. |1-2 points |0 points | | |

| |7-10 points |3-6 points | | | | |

|Plan of Action / |Plan of Action / Timeline is |Plan of Action / Timeline is |Plan of Action / Timeline is not |Plan of Action / Timeline is |  |/5 |

|Timeline |clearly stated with realistic |clear with realistic dates that |clear or is not realistic for |not included. | | |

|5 Points |dates that are attainable. |are attainable. |successful completion of project.|0 points | | |

| |4-5 points |2-3 points |1 point | | | |

|Evaluation |Evaluation component is built into|Evaluation component is built |Evaluation regarding the |Evaluation is not addressed. |  |/10 |

|10 Points |the project. Methods for |into the project. Methods for |effectiveness of the project is |0 points | | |

| |evaluating the effectiveness of |evaluating the effectiveness of |not specific. | | | |

| |the project are included and |the project are included. |1-2 points | | | |

| |specific evaluation activities are|3-6 points | | | | |

| |identified. | | | | | |

| |7-10 points | | | | | |

|Budget |Detailed budget with items and |Detailed budget with items listed|Budget provide but some items |Budget is not included. |  |/10 |

|10 Points |costs listed. |and estimated costs on most |and/or costs incomplete. |0 points | | |

| |7-10 points |items. |1-2 points | | | |

| | |3-6 points | | | | |

    TOTAL /100

-----------------------

Foundation Headquarters Use Only:

Date Received:

Foundation Headquarters use only:

Approved by:

Name: Signature:

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