Applicant's Name *

Mailing Address

Email Address *

Telephone

Job Title

If you work at a school, please provide your principal's name and email address.

Project Title

Budget Request

This may not exceed $1,000.

Please write a one-paragraph summary description of your project.

Why do you believe there is a need for this project?

Please elaborate on the main challenge, opportunity or objective this project addresses?

How will your project connect education and the business community?

Describe your project with particular focus on how it will build relationships or understanding between education and the business community.

Please provide a schedule of events and activities that will be part of your project.

Approximately how many students will be involved or impacted by this project?

Please explain how they will be engaged and how you arrived at your number.

How will you determine whether your project is successful?

Please elaborate on how you will determine whether your objectives have been achieved.

Will you share your ideas with other classes, schools, and/or organizations?

Please provide a specific and detailed budget for your project.

Include information such as materials, sources of supplies, and costs. We encourage you to purchase from local Chamber member businesses whenever possible. A list of members can be found on our website at my.concordnhchamber.com/activememberdirectory.

Example:

Item	Supplier	Budget Amount
Six (6) Learning to Read Books	Gibson’s Bookstore	$40.00

Please upload any documents you would like to share.

20MB max