Chelsea & Andre Kozaczka Award Application

Through its Student Program Investment Grant Awards, The Patrick Spann Foundation is pleased to announce the opening of the Chelsea & Andre Kozaczka Award. Due to their generous donation in collaboration with LuLaRoe, for this award, The Foundation is accepting applications from 501(c)3 not-for-profit organizations serving in the areas of STEM training, mentorship, and community service. The award provides $500 to $1,000 in funding for programs that serve 7th – 9th grade students who have academic promise in one or more of the STEM fields but lack the educational and social resources that are important to breaking the barriers to economic advancement.

The Patrick Spann Foundation’s Student Program Investment Grant Awards are tasked with growing the presence women, African Americans, Hispanic Americans, Native Americans, and adults, who were raised by low-income families in the STEM professions and prepare them for rebuilding their communities through community service.

To be considered, please describe how your organization can help us meet our goal by completing the application below.

SPECIAL NOTE:  The Partner Organization Application must be also submitted for consideration of this award.

KEY DATES:

  • Grant applications will be accepted between Jan.1, 2017 and Mar. 31, 2017.
  • Awards will be announced on or before July 22, 2017.
  • Proposed activities must be completed within one-year after receiving the award.

Questions?
Contact Colette Knuth at cknuth@thepatrickspannfoundation.org.


G R A N T
A W A R D
A P P L I C A T I O N


All fields are required.

Organization:

Are you a 501(c)3 tax exempt organization? (Yes/No)

What is your organization's EIN?:

Organization Website URL (optional):

Street Address:

City:

State:

Zip:

Contact Person:

Phone:

Email:


Proposed Activity

Briefly describe how you will use the award.


Expected Outcomes of Activity (Performance Metrics)

Please indicate what the activity is expected to accomplish in terms of outcome metrics (i.e., 10 more students trained, .5 increase in student school GPA as a result of mentoring, 100 more hours community service performed by students, etc.). Organization awardees will be required to provide us with an outcomes report at the end of the award period.


Student Awards

We welcome the opportunity to support individual student(s) of great promise with this award. Please use the space below to describe this aspect of your proposed activity. If this is your proposal and it is awarded, note that in your award letter we will request that for every student you nominate (1) short bio (name, age, grade), (2) headshot photo, and (3) a statement of how this award will advance their goals.


Budget

Please provide a summary of the budget for this project. Include the cost of any items that are significant to the success of this project (i.e. staff, equipment, supplies, etc.).


Schedule of Activities

Please list the approximate dates in which the components that comprise your activity will start and end.



D O C U M E N T A T IO N


Please list below any documents that you are submitting with this application:

UPLOAD YOUR DOCUMENTS

Accepted file types: acceptable file types (extensions) are: jpg, pdf, doc, docx, ppt, pptx. Acceptable file size is 1 MB (1048576 bytes).


S U B M I T
Y O U R
A P P L I C A T I O N

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