Project Title:

Grant Category (check one):
Individual Classroom  Team/Grade Level  Sch./Corp.-wide
Project Director(s):

Position:
Daytime Phone: Evening Phone:
E-Mail Address:
School(s)/groups targeted for grant:

Approx. # of students impacted: Grades:
Total Project Budget:
Total PHMEF Funds Requested:

As the party(ies) responsible for the execution and administration of the proposed project, the undersigned pledge to:
    Submit a detailed accounting of all P-H-M Educational Foundation funds expended as part of this grant.
    Submit a Grant Project Evaluation Form within thirty (30) days of completing this grant, but no later than
                June 15, 2008.
    Take digital photographs, collect work samples, and/or other visuals for publicity purposes and submit to
               the PHMEF office in the ESC at 55900 Bittersweet Road.  
    I/We recognize that providing the accounting, reporting and publicity items listed above are a condition
                of funding and therefore are my/our obligation as a grant recipient.

Project Director: (PRINT)

Signature:

Date:
Comments and signature of the Director of Information and Technology Services (if requesting funds for technology equipment): (PRINT)

Signature:

Date:
Principal and/or Superintendent: (PRINT)

Signature:

Date:

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