MRTF MISSOURI RETIRED TEACHERS FOUNDATION 877-366-MRTA 3030 DUPONT CIRCLE JEFFERSON CITY, MO 65109 WWW.MORTF.ORG MISSOURI RETIRED TEACHERS FOUNDATION CLASSROOM GRANT APPLICATION COVER SHEET Deadline: Application Cover Sheet and Sections 1 through 5 materials must be post-marked June 30 (include original and two copies of everything). Funds: Funds may be appropriated in the areas of resources, leadership, research, or materials used by an active Missouri classroom teacher. A minimum of forty-two (42) $500 grants will be awarded (three per MRTA Region, see map enclosed). Winners: Winners will be notified by September 15. A one page follow-up report is requested from the grant recipient by April15 of the following year. Thank you for your interest and intent to further the excellence of education in the State of Missouri. For questions about this application, please contact the MRTA office at 1 (877) 366-6782. Applications may be downloaded at www.mortf.org. NAME OF APPLICANT_____________________________________________________________________ E-MAIL ADDRESS OF APPLICANT__________________________________________________________ APPLICANT HOME PHONE (____)_______________ APPLICANT CELL PHONE (____)_______________ SCHOOL DISTRICT_______________________________________________________________________ COUNTY________________________________________________________________________________ SCHOOL NAME__________________________________________________________________________ SCHOOL OFFICE PHONE ( )_______________ SCHOOL ADDRESS City/State/Zip Code_______________________________________________________ ________________________________________________________________________________________ NAME OF LOCAL NEWSPAPER_____________________________________________________________ WEBSITE, PHONE # & CITY OF NEWSPAPER _________________________________________________ ________________________________________________________________________________________ Office Use Only: MRTA Region_________ By giving, you leave a legacy; you create a memory that will not fade. MRTF is a 501(c)(3) not-for-profit charitable corporation. MISSOURI RETIRED TEACHERS FOUNDATION GRANT APPLICATION SECTIONS SECTION 1. Title and Description In 50 words or less, describe your school or classroom project. Please identify the population involved and include a detailed description of the demographic area for which the funds will be used. SECTION 2. Purpose of the Project State the overall goal or objectives for pursuing your project. Explain what you hope to accomplish at the completion of the grant. SECTION 3. Evidence of Need Demonstrate the need for your project. SECTION 4. Planning Address any previous planning that you or your school completed prior to submitting this application. Then describe what you plan to do in a systematic schedule or plan of action. Include approximate dates with each planned activity from beginning to completion. How do you plan to evaluate the success of the project? SECTION 5. Proposed Budget Explanation Attach a detailed list of all materials, supplies, and equipment, rental or purchase costs to show how the grant money will be spent. Include the supply company and cost by item. If the school district or another organization will share in the total cost, please detail their contribution beyond the $500 grant. APPLICATION CHECKLIST ASSEMBLE YOUR APPLICATION IN THIS ORDER. 1. 2. APPLICATION COVER SHEET SECTIONS 1 THROUGH 5 COMPLETED. SECTIONS 1 THROUGH 5 SHOULD NOT EXCEED 5 PAGES. THE APPLICATION COVER PAGE DOES NOT COUNT TOWARD THE 5 PAGES. REMINDER: YOU MUST SUBMIT THE ORIGINAL AND TWO (2) COPIES OF THE APPLICATION COVER SHEET AND SECTIONS 1 THROUGH 5 MATERIALS TO THE MRTF OFFICE POST-MARKED BY JUNE 30. By giving, you leave a legacy; you create a memory that will not fade. MRTF is a 501(c)(3) not-for-profit charitable corporation. Missouri Retired Teachers Association Regional Map – 14 Regions Atchison Holt Nodaway Worth Putnam Harrison Gentry Dekalb Buchanan Platte Clinton Clay Daviess Scotland Region 3 Livingston Linn Macon Marion Caldwell Rall s Monroe Chariton Carroll Ray Randolph Saline Lafayette Pike Johnson Howard Pettis Boone Region 4 Montgomery Morgan Benton Miller Hickory Cedar Dallas Polk Osage Gasconade Phelps Laclede Crawford Washington Saint Francois Dent Greene Webster Christian Barry Stone Perry Region 11 Wright Texas Region 10 Bollinger Wayne Carter Douglas Howell Taney Ozark Cape Girardeau Madison Shannon Lawrence McDonald Ste. Genevieve Iron Reynolds Newton Hwy. 340 (Olive St.) Jefferson Region 8 Dade RegionJasper 9 Franklin Maries Pulaski Vernon Saint Louis Saint Louis City Region 7 Camden Region 14 Saint Charles Moniteau Region 6 Saint Clair Lincoln Warren Callaway Cole Henry Region 13 Audrain Region 5 Cass Barton Lewis Shelby Cooper Bates Clark Knox Region 2 Jackson Adair Sullivan Grundy Region 1 Andrew Schuyler Mercer Oregon Ripley Scott Stoddard Region 12 Mississippi Butler New Madrid Pemiscot Dunklin