FIRST Team Grant Application

Program

Thanks for applying for a {program} program grant. We have one application form to handle several grant sources and your team will be considered for all grant sources that we have available.

Your Name*

First NameLast Name

Preferred Contact

Phone Call - WeekdayPhone Call - EveningEmail

phone number - weekday:

phone number - evening:

E-mail*

example@example.com

city:*

Your Role*

Team Affiliation*

Name of School or Nonprofit

Team Status

Team is a new team with all team members identifiedteam is a new team that is just forming and not all members are identifiedteam is a returning team with all team members identifiedteam is a returning team with not all members identifiedOther

Do you have a 2nd email address that you would like a copy of this application to go to?

2nd Email

YesNo

Email

example@example.com

School District(s) Represented*

District(s) represented by Youth Team Members

Are school(s) listed as aTitle 1 school?

YesNo

Number of Team Members*

Team Size

Number of Adult Coaches or Mentors*

Number of Adults working with team

Number of Youth Mentors*

Number of Youth Mentors working with team

City Where Team Regularly Meets*

If team meets in multiple cities, enter one primary city

Grade Levels*

Please specify the Grade Levels of Team Members

New to FIRST*

Everyone is new to FIRST this seasonOne or More Team Members, Coaches or Mentors have participated in FIRST previouslyOther

Other FIRST*

FLL ExploreFLL ChallengeFTCFRC

Other FIRST experience?*

FLL ExploreFLL ChallengeFTCFRC

Team Registration Status*

The team has registered and paid for this season with FIRSTThe team has started registration, but not paid this season with FIRSTThe team has not registered this season with FIRST

FIRST Team Number

Do Any Mentors or Coaches Receive a Stipend or Compensation related to this activity?*

YesNo

How are the coaches and mentors connected to the team? *

Please explain how the Coaches and Mentor are connected to the team

Instructions for Team Member demographics entries below

Confirmed? : This is a yes/no question. If this student is a confirmed team member and the Gender, Ethnicity/Race, Free/Reduced Lunch, and zip code are accurate for this student, then please enter Yes. If the student is an expected team member and/or some of the information is not accurate, then please enter No.

Gender : Please enter one of the following for each student: Boy, Girl, or NonSpecified

Ethnicity/Race : Please enter what the team member identifies as their primary ethnicity or race. This should be one of the following for each student: White, Hispanic, African American, Native American, Chinese Asian, Indian Asian, Other Asian, Multiple Races, Decline to State or Other. If Other, please add explanation in comment box at end

Free / Reduced Lunch : Please enter Yes if the student would be eligible to receive a free or reduced lunch per the household income eligibility set by CA. Otherwise, please enter No

Zip Code : Please enter the home zip code for each student

Team Member 1*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
1

Team Member 2*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
2

Team Member 3*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
3

Team Member 4*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
4

Team Member 5*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
5

Team Member 6*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
6

Team Member 7*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
7

Team Member 8*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
8

Team Member 9*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
9

Team Member 10*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
10

Team Member 11*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
11

Team Member 12*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
12

Team Member 13*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
13

Team Member 14*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
14

Team Member 15*

Rows	Confirmed?	Gender	Ethnicity/Race	Free / Reduced Lunch	Zip Code
15

What is the total Requested Grant Amount (in US Dollars)?*

Request*

Rows	Requesting from this Grant	Already Have or Funded	Other Grant Request in Process
Annual FIRST Team Registration
Annual Regional Registration Fees
Robot Kit
Annual Game Elements / Challenge Kit
Field / Challenge Table
Computer
Team Materials (tshirts, Snacks, etc)
Other - (Add Details in Budget File )
Regional Championship Fees

Please provide a team budget that shows all expected team expenses as well as all funding sources. Please include donated and in-kind items.

Budget*

Browse Files

Describe Financial Need*

What barriers do you have that prevent you from securing funds from other sources?

Describe Value to Team Members to Participate in FIRST*

Grant Conditions*

Rows	Yes	No
We understand that if our team is awarded a grant, we need to submit a signed letter (on school or organization letterhead) accepting these grant conditions
If we have not done so yet, we will complete national FIRST team registration for this coming season
We have at least 2 adults that are willing and able to be coaches and pass the FIRST background screening
We will register and participate in an official tournament (or League Tournament) in our region .
We agree that if we are awarded a grant, we may need to add specific sponsor recognition to team materials such as team tshirts, website, etc
We have registered (or will register) enough teams for all youth participants based on the maximum Team Size allowed in our program (6 for FLL Explore ; 10 for FLL Challenge ; 15 for FTC)
We agree to participate in a post-season survey/evaluation process to gather information about what teams and coach/mentors experienced during their season

Comments

Please add any additional details if needed

FIRST® Team Grant Application