Applicant Information
Teacher name:
School:
Principal/ Head of school:
School address:
City:
State:
Zip code:
School phone:
Home phone:
Home address:
City:
State:
Zip code:
E-mail address:
Grade level:
Subject area:
Number of students:

Priority is given to applicants who have participated in one or more of the following. Check all that apply.

Attended AEP Workshop for Educators or E-LAB.
  Date Attended:
  Course:
  Location:
     
Attended NEED training.
  Date Attended:
  Course:
  Location:
 
Affiliated with an official AEP school-business partnership.
 
  List name of AEP employee who coordinates the partnership:
  Name:

Project Information

Title of Project (Limit 70 characters or about 10 words): chars. left


State the major objective of your project (Limit 200 characters or about 30 words):chars. left

Provide a brief description of the project including additional objectives not covered in the preceding statement. (Limit 4000 characters or about 550 words): chars. left

Describe specific means of evaluating each objective (i.e. pre-post test, portfolio, report, etc..) (Limit 750 characters or about 125 words): chars. left

List the steps to be used in implementing the project. Include a brief timetable. (Limit 750 characters or about 125 words): chars. left

How will the project be shared with other educators? (Limit 750 characters or about 125 words): chars. left

Will the project be shared with parents or the community?
If so, how? (Limit 750 characters or about 125 words): chars. left

Total Amount Requested $ (minimum $100, maximum is $500).

Itemize your anticipated expenses. Receipts and a project summary/evaluation are to be submitted by Oct. 23, 2009. (Limit 750 characters or about 125 words): chars. left

Checks will be made payable to the teacher unless you indicate otherwise by providing the name of the school, PTO/PTA or other organization to whom the check should be made payable.:

Please read and check the boxes to signify agreement with the following statements:
I understand that the awarding of all grants and the amount of any grant shall be at the discretion of American Electric Power (AEP). I further understand that, in the event I am awarded a grant for the project, AEP shall have the right to disseminate a description of my project and its concepts and ideas.
Date: (mm/dd/yyyy)


The principal, head of school or curriculum supervisor, (list the most appropriate name) , (list title) , has reviewed and supports this application.


Print a copy of this application for future reference before you submit.

After clicking the Submit Application button, watch for a confirmation message. If you do not see a confirmation message, click the Submit Application button again.