Monroe Community College Preliminary Grant Approval Form Date: Project Director: Department: E-mail: Phone: Relates to Strategic Direction (check as appropriate): ___ 1 Learning First ___ 2 Workforce Education & Career Pathways ___ 3 Partnerships ___4 Effectiveness, Efficiency, & Accountability Is there an identified funding source? ____ If yes, please identify the source (agency and grant title) and submission deadline: ___________________________________________________________________________________________ Working Title of Project: Is this project a collaborative? _________ If so, is MCC the lead? __ If not, who is the lead? ______________________ Who is the external contact person? _________________ Contact Info: _________________________________________ Are letters of support required? ___________ If so, how many and from whom? If letter of support is needed by MCC, who is required signature? _________________ I have discussed and received approval to move the project forward from my: Director/Department Chair ________________________ Name _____________________________ Signature ___________________ Date Dean (if applicable) ________________________ ______________________________ Name Signature ___________________ Date Asst. and/or Asso. VP (if applicable) ________________________ _______________________________ Name Signature ___________________ Date Will release time or direct funds be requested for you? _______ Summer Salary? ______ If “yes”, please describe: Will release time and/or summer salary be requested for other faculty/staff? ________ If “yes”, please describe and indicate how many faculty/staff, number of hours, and identify (if known), or titles. Projected number and types of grant funded positions: Estimated Total Budget: (budget and staffing to be detailed in budget section below) If known, is there a cost-sharing or endowment requirement? If so, how will this be addressed? Describe what new or existing space will be required. Are new computers/technology/software needed? Yes No Explain: Number of Students Impacted: PROJECT NARRATIVE: Please provide an overview of the proposed project and its relationship to the strategic plan, the project goals and objectives, proposed activities, proposed outcomes/sustainability of project, and a projected budget. Brief Project Overview (3-6 pages describing the project to include the need (to the College, the community, the field of study, and/or students), how will the project address the need, how does this project relate to the strategic plan, indicate all departments that will be involved – both directly and indirectly, list the project goals and objectives, projected activities, and timeline for the project. If the project is a collaborative, describe the partnership. Projected Outcomes/Sustainability Plan: What will be the results from the project? How will the project be sustained by the college after the grant funding expires? Budget Overview: Understanding this is not the final budget, please provide general information for the projected budget within the following categories: Personnel (include full-time, part-time, and summer salary for MCC employees, number and types of proposed grant positions – including coverage for release time - with projected salary, months of employment, and cost). Fringe Benefits – 43% for full-time and college positions, 17% for part-time positions Travel – include cost for mileage, meals, conference fees, and purpose of travel. Equipment – Items valued at $5,000 or more for each item. (grant definition) Supplies – items valued at $4,999 and less for each item. (grant definition) Contractual – expenses for services that will be contracted for by an external vendor; these may include an evaluator, minor remodeling, installation, etc. NOTE: Insert Category Personnel General Item Description Sub-Totals Category Totals Fringe Benefits Travel Equipment Supplies Contractual Totals I acknowledge I will work with grants staff in the development of a full proposal upon approval of the Vice President Team. Applicant Date The Divisional Vice President has reviewed and hereby approves this project for development of a full proposal. __________ Divisional Vice President VICE PRESIDENT TEAM: ______________. Date Approved Disapproved If applicable, recommendations from the Vice President Team are attached.