Ivey’s Everyday Heroes Grant Application

The application must be filled out completely to be considered. All incomplete applications will be returned unprocessed; there are no exceptions for late or incomplete applications.
Name*

First NameMiddle NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
U.S. Citizen*

YesNo
Please Select The Type of Nominee You're Applying For*
High School Information (for student nominees)
Name of High School*
High School Address*

Street Address

Street Address Line 2

CityState

Zip Code
Did the Nominee Already Graduate?*
Year*
Did the nominee achieve a GED?
Year*
Employment Information (for staff nominees)
Name of Associated School or School District*
Your Position (e.g. teacher, safety resource officer, administrator)*
Employment Address*

Street Address

Street Address Line 2

CityState

Zip Code
U.S. Military or Law Enforcement Career Information
If current or former military, in which branch of the U.S. military did the nominee serve?*
If law enforcement, what role do you serve related to school safety?*
Grant Applicants (person nominating to complete)
What led the nominee to step forward and take action?*
In your best thinking or experience, what might have happened had the nominee not have stepped forward to take action?*
What is your relationship to the nominee?*
Additional Information Required Before Application Can Be Reviewed
Include two letters of recommendation from (a non-family member) a current or former educator, school administrator or counselor, law enforcement commander/leader/supervisor on official letterhead.
Letters of Recommendation*

Cancelof
Should be Empty:

High School Information (for student nominees)

Employment Information (for staff nominees)

U.S. Military or Law Enforcement Career Information

Grant Applicants (person nominating to complete)

Additional Information Required Before Application Can Be Reviewed