Northland JC Foundation
2015 Academic Fellowship Grant
Purpose: The purpose of the NJCF Fellowship Grant is to provide a resource for teachers
/ administrators to apply, to subsidize special projects / programs that may not be covered in the normal operating budget.
Guidelines: Applications must be received by the NJCF no later than May 1, 2014, for
the 2014-15 academic years. Selection and notification will be made no less than 30 days prior to the start of the semester
in which the program will be implemented. Applications are to be submitted to the Northland JC Foundation, Academic Fellowship
Grant Committee at 6300 N. Indiana, Gladstone,, MO 64119. A maximum grant of $1,000.00 will be awarded. For further information,
contact David Page at (816) 436-1555 or DPagekcmo@aol.com.
School name: _________________ District: _________ Date submitted: ________
School Address: _______________________________________________________
(Street City State Zip code)
Project Name: _________________________________________________________
Sponsor’s Name: _________________ E-mail address:
Business phone Fax #: P____________________, F ________________________
Fellowship granted or denied (summer) contact information if different from above:
Course / Class name Curriculum Category: __________________________________
Date of program or semester(s) of study: ___________________________________
Specific request (amount: ________
Number of people to be impacted: ________
Date program would be implemented: __________________
Date program would complete: _______________________
Date funds would be needed: _________________
Program Description & Planning Guide
(Attach additional sheets as needed)
1. Primary purpose for conducting this project or program?
2. Provide a brief description of the proposed project including background information.
3. What are the specific goals and objectives to be achieved? How do they relate to the curriculum master plan?
4. What are the specific manpower assignments? (Show titles
5. What specific materials, supplies, and resources will be required?
6. Describe the potential problems and solutions
to successfully complete this project.
7. Complete a proposed budget indicating all anticipated income and expense. (Use separate
8. List the specific steps to bring this project to a successful completion showing planned dates for each step.
9. Describe how program, or individual(s), involved or affected, will benefit from conducting this proposal.
awarded the fellowship, I, the undersigned, agree to allow the Northland JC Foundation to use any pertinent information in
the promotion of the NJCF without additional compensation and to provide such agency with follow-up information regarding
the use of the funds. Additionally, I agree that all information provided is true and complete.
of applicant X _____________________________ Date __________