Air Expressions
Application Form
Please print and complete this application form and return to:
Julia Duran, MBUAPCD, 24580 Silver Cloud Court, Monterey, California 93906
or e-mail to jduran@mbuapcd.org
APPLICATION DEADLINE 5 PM:
OCTOBER 17, 2014
PROJECT LEADERS SCHOOL/ORGANIZATION INFORMATION
Student Project Leader:
Contact Phone Number:
e-mail address:
Academic Advisor:
Contact Phone Number:
e-mail address:
School Name or
Organization:
School District:
Mailing Address:
Grade(s) taught:
Number of Students:
County: Monterey:
Santa Cruz:
San Benito:
REQUIRED SIGNATURES
Student Project Leader’s Signature:
Date:
Academic Advisor’s Signature:
Date:
Principal’s Signature:
Date:
Air Expressions
Application Form
Project Abstract and Work Plan
PROJECT ABSTRACT
Submit a Project Title/Name and Project Abstract by describing your project in less than 300
words. Please include project milestones and budget expenses. Be sure to explain how you plan
to use the possible grant award to express your creativity and ideas as they relate to air quality
and clean air.
Insert Project Title/Name:
Insert Abstract here:
PROJECT WORK PLAN AND BUDGET
Include your detailed project work plan including; Project description, project milestones, budget
expenses and expected deliverables and outcomes. Include a statement of how the awarded grant
fund will be spent.
Insert Project Work Plan & Budget: (See Application Requirements)
Include advertising, technology, equipment, supplies, materials, services, travel, leveraging of
other sources and any other expenses.
Total grant amount requested: $