MDABESTRobotics Grant application LEA NTPD.pdf

MDA BEST Robotics Grant: Local Education Agencies (LEA) National Teacher Professional Development (NTPD) 2017

Completed forms should be saved and submitted as SchoolDistrictName_MDABESTRoboticsGrant_LEANTPD_2017.

If there is any confusion, please refer to the actual grant for clarification.

1. Local Education Agency (LEA) Information

a. DUNS Number: b. Name:

c. Mailing Address:

City: State: ZIP Code:

d. Number of Middle Schools: e. Number of High Schools:

2. Local Education Agency (LEA) Grant Application Point of Contact Information

This person must be a central system/district administrator.

a. Name: b. Title/Position:

c. E-mail Address: d. Phone:

e. Mailing Address:

City: State: ZIP code:

3. Hub Information

a. Director’s Name: b. Hub’s name:

c. Director’s E-mail Address: d. Director’s Phone:

e. Hub’s City: State:

4. Funding and Teacher Information

Please enter the lead teacher/trainee’s information, up to 5. If your LEA is proposing less than 5 lead teacher/trainees, you will not use all the space provided.

a. Total Requested Funding Amount:

b. Name: c. School:

d. First Year as Team Teacher: e. Full-time Teacher: YES ☐ NO ☐

Funding f. Lodging: g. Food: h. Travel:

b. Name: c. School:

d. First Year as Team Teacher: e. Full-time Teacher: YES ☐ NO ☐

Funding f. Lodging: g. Food: h. Travel:

b. Name: c. School:

d. First Year as Team Teacher: e. Full-time Teacher: YES ☐ NO ☐

Funding f. Lodging: g. Food: h. Travel:

b. Name: c. School:

d. First Year as Team Teacher: e. Full-time Teacher: YES ☐ NO ☐

Funding f. Lodging: g. Food: h. Travel:

b. Name: c. School:

d. First Year as Team Teacher: e. Full-time Teacher: YES ☐ NO ☐

Funding f. Lodging: g. Food: h. Travel:

Approved for Public Release 17-MDA-9114 (29 March 17)

MDA BEST Robotics Grant: Local Education Agencies (LEA) National Teacher Professional Development (NTPD) 2017

Attachments

When saving and submitting your attachments, please use the names listed below. Your attachments should be labeled with the appropriate attachment name and submitted with your application.

Attachment Name Description Submitted on Grants.gov

5. Support Letter 1 A signed support letter on official letterhead from Local Education Agency’s (LEA’s) superintendent

YES ☐

NO ☐

6. Support Letter 2 A signed support letter on official letterhead from local BEST Robotics hub verifying all teachers identified in the grant have participated as team teacher during the previous year (be sure that EVERY teacher is listed in the letter)

YES ☐

NO ☐

7. Post-Award Agreement

A signed letter of acknowledgement and agreement from Hub Director on official college/university letterhead to provide MDA STEM with required post-award reporting, including but not limited to, demographic information, information briefs, videos, and/or photographs

YES ☐

NO ☐

8. SAM certification A certification that SAM information is current

YES ☐

NO ☐

9. WAWF certification A certification that a WAWF account is current

YES ☐

NO ☐

Approved for Public Release 17-MDA-9114 (29 March 17)