Program Summary Form Prior and/or Current After-School Experience/ Funding Sources (check all that apply): Extended School Day Federally funded program: Advantage After School __________________________ 21st Century Community Learning Centers Locally funded program: Beacon Program _________________________ New York City OST Program Other: ___________________ Student Populations to be Served in this Grant (check all that apply): Elementary Middle School High School Types of Service Providers Participating in this Grant (check all that apply): National Organizations County or Municipal Agencies (e.g., police, (e.g., Boys & Girls Parks & Recreation, Social Services) Clubs, YMCA/YWCA, Big Brothers/Big BOCES Sisters) Community-Based Organizations Faith-Based Organizations (local Hospitals/Clinics/Health Providers or foundations) Libraries or Museums Public School District Businesses For-Profit Corporations Colleges or Universities Other Services to be Provided in this Grant (check all that apply): Academic Physical Fitness, Wellness Health Support/Enrichment Technology, Video or Media Nutrition Mathematics Library Services Youth Development Science Family Literacy Drug/Violence Prevention English Language Arts Other Family Education Counseling Social Studies Tutoring/Mentoring Character Education Art, Music, Dance, Theater Internships/Externships Service Learning Entrepreneurial Education STEM Other ________________ Is the application for a school-wide proposal that will serve grades 6-8? Yes: 5 points. No: 0 points. Does the applicant plan to implement extended-learning time by changing the school day, week and/or year during the 2013-14 school year equivalent to at least half of the extended learning time of a full school year? Yes: 5 points. No: 0 points Does the applicant plan to serve students who attend: a. schools eligible for school wide programs under Title I, Section 1114 of the No Child Left Behind Act, or b. schools with at least 40 percent of its students eligible for free or reduced price lunch. A complete list of eligible schools is available at: . Yes: 10 points. No: 0 points
Program Summary Form Prior and/or Current After-School Experience/ Funding Sources (check all that apply): Extended School Day Advantage After School 21st Century Community Learning Centers Beacon Program New York City OST Program Federally funded program: __________________________ Locally funded program: _________________________ Other: ___________________ Student Populations to be Served in this Grant (check all that apply): Elementary Middle School High School Types of Service Providers Participating in this Grant (check all that apply): National Organizations (e.g., Boys & Girls Clubs, YMCA/YWCA, Big Brothers/Big Sisters) Community-Based Organizations (local or foundations) Libraries or Museums Businesses Colleges or Universities County or Municipal Agencies (e.g., police, Parks & Recreation, Social Services) BOCES Faith-Based Organizations Hospitals/Clinics/Health Providers Public School District For-Profit Corporations Other Services to be Provided in this Grant (check all that apply): Academic Support/Enrichment Mathematics Science English Language Arts Social Studies Art, Music, Dance, Theater Entrepreneurial Education Physical Fitness, Wellness Technology, Video or Media Library Services Family Literacy Other Family Education Tutoring/Mentoring Internships/Externships STEM Health Nutrition Youth Development Drug/Violence Prevention Counseling Character Education Service Learning Other ________________ Is the application for a school-wide proposal that will serve grades 6-8? Yes: 5 points. No: 0 points. Does the applicant plan to implement extended-learning time by changing the school day, week and/or year during the 2013-14 school year equivalent to at least half of the extended learning time of a full school year? Yes: 5 points. No: 0 points Does the applicant plan to serve students who attend: a. schools eligible for school wide programs under Title I, Section 1114 of the No Child Left Behind Act, or b. schools with at least 40 percent of its students eligible for free or reduced price lunch. A complete list of eligible schools is available at: . Yes: 10 points. No: 0 points
ETL-Grant-Application.docx