Let's Move Pittsburgh Champion Schools Award 2019

1. 2019 Champion Schools Application

Question Title

* Please select the type of award you are applying for:

Champion Schools Seed Mini-Grant ($1,000): This application is for schools that are proposing a new program and are in need of tools and resources to turn their ideas into action. These Champion Schools will be awarded funding for implementing their new program.

Champion Schools Awards Mini-Grant ($1,000): This application is for schools with an existing program or project that is already in place and can provide Let's Move Pittsburgh with evidence of impact. These projects will be celebrated for their great work and awarded funding for continued support.

Question Title

* Champion Schools lead or project manager:

Name

Position/Role

E-mail Address

Phone Number

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* A co-lead is required for the Champion Schools Project. Please provide the contact information for your program co-lead.

Name

Position/Role

E-mail Address

Phone Number

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* Please provide the names, position/role and email of any additional project team members (including, but not limited to educators, administrators, parents, nurses, school food professionals, school wellness committees, etc.).

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* School or Child Care Facility Information:

School/Child Care Facility Name

District (if applicable)

Address Line 1

Address Line 2

City/Town

Zip Code/Postal Code

Phone Number

If you are a childcare center applying, is your facility currently licensed by the state of Pennsylvania?

If you are a childcare center applying, is the facility currently involved with the Keystone STARS initiative?

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* School or Child Care Facility Data

Number of Students

Percentage of Students Eligible for Free and Reduced Price Lunch

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* Please submit the principal's name and email. By submitting this information, you are confirming the principal approves of this mini-grant proposal.

Name

Email Address