Innovator Grant Application

In order to expedite payment of funds if your application is selected, we require your signature on a conditional agreement form and submission of a W9 in your name (not your school). You will not be taxed on your grant funds, if selected. Please download and sign the Innovator Grant Agreement Form. After you have signed the agreement, please use the file upload form below to return the document to us. This form does not guarantee that you will be selected, and your application will not be considered without it.

Click here to download the Agreement Form

Upload your completed and signed Agreement Form*

You will also need to download and fill-out an IRS W-9 Form. After you have completed the form, please use the file upload form below to return the document to us.

Click here to download an IRS W-9 Form

Upload your completed and signed W-9 Form*

Name*

First NameLast Name

Mobile Number*

Project Name*

Short, creative, descriptive

Budget*

	Item to Purchase	Quantity Needed	Cost of Item
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Grand Total

Total Budget: ${calculation}

Total Project Budget*

Have you secured the additional funds needed?*

YesNo

Please list source(s) of additional funds and amount(s) secured.*

Please explain how you will secure additional funds needed and when.*

Total amount you are requesting from The Education Fund *

M-DCPS Employee #*

Full School Name *

School Location Number *

M-DCPS Email Address*

example@example.com

If you are a Charter School teacher, enter your work email.

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Has your principal been notified of this application? (For your application to be considered, school administrative personnel must be made aware of your submission.)*

YesNo

Names of Other Team Members (if any)

Teaching Assignment: Grade Level and Subject Area *

Total number of students that you teach*

Number of Students Participating *

Level of Achievement*

Regular, ESE, Level 1, etc.

Summary of your project (one paragraph)*

Please include who, what, why, and how – bullet points acceptable.

Describe how this this project is innovative.*

Describe your project idea in detail. *

What are examples of envisioned student activities?*

Bullet points acceptable

What need does this project fill? *

Projected Timeline*

Please provide a list of activities by month, starting in October, to show that the project is well planned.

Project Objectives*

Project Evaluation*

How will you determine if your objectives have been met?

Signature*

Powered by Jotform SignI certify that the information I have provided is true and accurate. Clear

Innovator Grant Application

Agreement Form & W-9

Project Description