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US Airways Grant Application

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2007 GRANT APPLICATION (Applications must use this form and be completed electronically or typed)

Date:  Applicant Organization Name (as shown shown on 501 (c) (3) letter): Mailing Address: City:

State:

Zip:

Executive Director(s):  Director(s):  Program Director: __  __ 

Phone:

Ext:  Ext: 

Program Director(s) email address: Program Title: Program Summary (25 words or less):

 ____________________________________________________________  _____________________________________________________________________________________ _________________________ When will the Program take place? Start:

End:

Please note funding will not be distributed until after October 1, 2007.

 Amount requested from US Airways Education Education Foundation (not to exceed $5,000) $5,000)   Total funding required for this Program: $ Program: $ Total annual organizational budget (not applicable for public schools): $ Percentage of total Program budget allocated to administrative costs: Do you receive funding from a federated campaign (i.e. United Way or United Campaigns)? Yes

%  No  No 

If so, what percentage of your annual operating budget do you receive from a federated campaign: Does a portion of your fundraising for this program go to your national organization? Yes



No  No 

If so, how what percentage?



Geographic area to be served by this Program:  Program:  Description of population segment to be served: Estimated number to be served: Has your organization received funding from the US Airways Education Foundation (formerly the America West We st Airlin es Education Foundation) in the past? Yes

No  No 

If so, when?  when? 

________

Title of Program funded and amount:  ____________________________________________________________________  _____________________________________________________________________________  _________  

 

Please answer Please answer the fo llowing questions (in 500 500 words or less) and us e additional page pages s as necessary:

Describe your organization and the community it serves:

 _______________________________________________________________  _______________________________ _______________________________________________  _______________  

Describe the educational program to be funded with support from the US Airways Education Foundation, Inc.:

 _______________________________________________________________  _______________________________ _______________________________________________  _______________   Specifically, how will money granted by the US Airways Education Foundation be used? State the specific goals you wish to achieve and describe the activities that will take place to reach those goals:

 _______________________________________________________________  _______________________________ _______________________________________________  _______________   You will be required to provide a follow-up report. How will you evaluate and measure the impact of the grant and how will the grant provide visibility to US Airways?

 _______________________________________________________________  _______________________________ ______________________________________________  ______________  

 

  Expenses   Expenses

Budget for the Program

Portion of budget to be supported by Education Foundation Grant

Personnel/Staff (include salary and benefits) a) Administrative

$

$

b) Teaching (including aides)

$

$

Total Personn el/S el/Staff  taff   Outside Fees and Services

$

$

a) Consultants

$

$

b) Other

$

$

Total Other Fees Fees and Se Servi rvi ces ces  

$

$

Remaining Operating Expenses  Expenses  a) Supplies/Materials  Supplies/Materials 

$

$

b) Other (please list)  list) 

$

$

$

$

$

$

$

$

Total Re Remainin maining g Operating Expenses

$

$

TOTAL CASH EXPEN EXPENSES SES

$

$

 ADDITIONAL  ADDITIONA L PROGRA M FUNDING/SUPPORT List principal sources and amounts of on-going annual support already secured for this educational program:

a)

$

b)

$

c)

$

THE FOLLOWING INFORMATION MUST BE INCLUDED TO COMPLETE THE GRANT  APPL ICATIONS. INCOMPLETE A PPLICA PPLICATIONS TIONS WILL NOT BE REVIEWED. 501 (c) (3) tax exempt letter   Detailed operational budget outlining all sources of financial support Board of Directors list, including business affiliations and addresses  _________________________ Executive Director’s Signature

Date

 

  ADDITIONAL NOTES:

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