School Program Grant Application

Name of School * Name of School Program or Project * Name of Applicant* Phone Number * Email Address * Street Address of School * City * State * Zip Code *

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Requested Amount of Money * Time Frame of Project or Program * Grange Contact or Connection *

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Please describe in paragraph form the scope of the program or project and how the Grange Scholarship money will be used. Also include who will be involved in the program or project, and how it will benefit our students and community. If applicable, please include a photo..

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If we are selected as a recipient of this scholarship, I give my consent to disclose my name and photo for use in press releases and other communications promoting the Grange Scholarship Program. I also pledge to come to a General Grange Membership meeting and speak about the impact of the scholarship and our program or project.

Applicant Signature *

Clear

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