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1. First Name

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2. Last Name

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3. Type of grant you received

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4. Primary email address

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5. Secondary email address

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6. Personal Phone Number

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7. School Name

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8. School District

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9. Provide a brief description of your project or travel experience. Include what the money was used for and how you or your school and/or C-GEO benefited. (250-300 word limit)

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10. Were any additional activities (outside the original scope of the grant) presented? If so, please describe.

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11. Provide the estimated number of hours you spent working on this program

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12. Target Audience(s) - check all that apply

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13. How many target audience members were impacted through this grant funding. If possible provide numbers for each audience type.

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14. What was successful about your project?

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15. Please provide some reactions (quotes) from participants and/or evaluation data that provides evidence on the success of this effort.

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16. How did your students' (or your other target audiences's) understanding or appreciation of geography change during your project? Please describe.

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17. Would you be willing to give a presentation on your project at the next GeoFest conference (typically every March).

*If you select Yes or Maybe we will contact you directly to discuss further

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18. If you received a Teacher Incentive grant, please answer the following two questions. 


Describe how you included your new geographic resources into your classroom.

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19. Please list the different types of teaching materials purchased/utilized.

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20. If you received a family geography night grant please answer the following nine questions.

What was the date of your Family Geography Night?

Date

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21. Would you be willing to serve as a mentor to someone near you that is interested in conducting a FGN?

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22. How many student helpers were involved in conducting this effort?

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23. How many volunteers were involved in conducting this effort?

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24. Did you invite a legislator to your event, as required in the terms of the grant?

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25. Who did you invite?

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26. Did she or he attend?

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27. Did your project receive any media attention? If so, please share the web link to where the story ran.

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28. If you received a Travel Grant, please answer the following four questions.

If you attended a conference, what was the name of the conference?

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29. If you gave a presentation, what was the title of your presentation and how many attendees were at your presentation?

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30. What benefits did you derive that will help you professionally, and how the experience may have enhanced your knowledge of geography and your ability to integrate it into your teaching

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31. Do you have any additional information that you would like to share about your experience based upon this grant opportunity?

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32. If at all possible, please attach up to five high quality photos of you and your students participating in your project. (File size limit 10 MB)

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33. If attaching photos, please attach one scanned document of the signed photo release forms of students who appear in the photos.

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34. Did you adapt, create or identify a resource or a lesson plan that could be added to the C-GEO web-page of resources?  If so, please share these resources below.

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