FTC-2019 - ORTOP TEAM SUPPORT AWARD APPLICATION for FIRST TECH CHALLENGE ROOKIE SCHOOLS/ORGANIZATIONS (Rover Ruckus)

Applicant Contact Information and Demographics

Welcome to FIRST Tech Challenge Oregon, implemented by the Oregon Robotics Tournament & Outreach Program. Upon submission of this application, it will be reviewed to determine how well you have researched preparing to start a team and how well your application meets the current financial needs criteria.

Complete the application for team(s) at one school/organization for FIRST Tech Challenge after reviewing the ORTOP Team Support information page. This application is for a school/organization who has never fielded a FIRST Tech Challenge team or has not had fielded a team since the Cascade Effect game (2014-2015).

2018-2019 ORTOP Team Support Award is administered by the Oregon Robotics Tournament and Outreach Program and funded by numerous ORTOP sponsors including Oregon Department of Education, Rockwell Collins, Google, Garmin, Qorvo, MJ Murdock Charitable Trust and others.

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* 1. Name of the applicant completing this application

Name:

Email Address:

Phone Number:

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* 2. Check the box(es) that best describe the role(s) of the person writing/completing the application

Teacher who plans to be the coach

Parent of a team member

Coach or Mentor for the team

Non-parent volunteer for the team

Other (please specify)

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* 3. Applicant, School or Organization Contact Information

School/Organization (if applicable): *

School District (if applicable): *

Mailing Address: *

Address 2:

City/Town: *

State: *

ZIP: *

COUNTY (not country): *

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* 4. ORTOP Team Support Award recipients are limited to teams in the states of Oregon and Washington (Skamania/Klickatat counties). What best describes your team's affiliation?

Public School

Public Charter School

Private School

directly managed by a non-profit organization as an after-school or weekend program

not affiliated with an organization or school; such as neighborhood team

non-profit organization affiliated club/troop not directly managed by non-profit organization

Homeschool team, not affiliated with any organization

Other (please specify)

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* 5. Using the links to demographic information available on the application information page.
Please provide the percentage of students at your school who receive free or reduced lunch. If your team members do not attend public school, please provide the free and reduced lunch percentage for the public school they are zoned to attend.

Name of referenced school/district

Percentage of Free at Reduced Lunch at referenced public school

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* 6. How many rookie FIRST Tech Challenge teams do you want to start at your school/organization and be included for consideration by this application? Explain if necessary. The average FIRST Tech Challenge team size is 9 students with a maximum of 15. Teams should have no less than 6 students.

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* 7. For which type of award are you choosing to apply? (Select one per application)

FIRST Tech Challenge - ROOKIE School (7th - 12th Grade) - School or Organization has never participated in FTC before

FIRST Tech Challenge - ROOKIE School (7th - 12th Grade) - School or Organization has participated in FTC but in the 2014-2015 season (Cascade Effect game) or prior.

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* 8. ORTOP Team Support Award Compliance Statement. If awarded an ORTOP Team Support Award, applicant/coach must: 1) Complete, sign and return the Award Assurance Letter with named coaches within 10 days of notification. 2) Maintain records of expenditures, including receipts, for three years after the award date and may be asked to submit documentation to ORTOP in the event of an audit 3) Complete a year-end report and/or questionnaire about student participation and program impacts.

Some funders have additional requirements; see descriptions of individual awards below for more information. Failure to comply will result in a loss of eligibility for future awards through ORTOP.

Yes, I understand and agree to the conditions of the ORTOP Team Support Award Compliance Statement.

No, I cannot agree to these conditions and I withdraw my application for an ORTOP Team Support Award.

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* 9. Based on the complete descriptions and eligibility found on the information page, please check the box(es) for the team support award(s) your team(s) wish to be considered. Please read and click carefully.

Oregon Department of Education: GEOGRAPHY: All of Oregon. TYPE: Must be a verifiable public school or public charter school or verifiable non-profit organization who runs after-school programs in public schools. PRIORITY CONSIDERATION: schools with high free and reduced lunch participation, diverse student demographics, targeted area of FIRST growth, districts with no FIRST teams. OTHER: If awarded teams must submit Assurance form with Principal or District Superintendent signature. Two rounds of funding Deadline to apply Round 1: Aug 1 and Round 2: September 30 (if funds remain)

Rockwell Collins - GEOGRAPHY: all of Oregon TYPE: public/private schools, organizations, home school, neighborhood PRIORITY CONSIDERATION: teams demonstrating financial need not eligible to apply for other awards

Qorvo: All of Oregon. TYPE: public/private schools, organizations, home school, neighborhood. / RESTRICTIONS: Teams in financial need who cannot pay the full cost of program fee for tournaments. Qorvo funds cover balance of what a team cannot pay.

Google Data Center in The Dalles (pending): GEOGRAPHY: Must be a team located in Hood River, Wasco, Sherman, Skamania or Klickitat Counties TYPE: Must be a verifiable public school team that meets in a public school in the counties listed above.

Insitu: GEOGRAPHY: Must be a team located in Hood River, Wasco, Sherman, Skamania or Klickitat Counties. TYPE: public/private schools, organizations, home school, neighborhood. PRIORITY CONSIDERATION: teams demonstrating financial need not eligible to apply for other awards

Garmin: GEOGRAPHY: Preferences given to teams in the Greater Salem Area and Marion County. TYPE: public/private schools, organizations, home school, neighborhood. / PRIORITY CONSIDERATION: teams demonstrating financial need not eligible to apply for other awards

FIRST Tech Federal Credit Union: TYPE: public/private schools, organizations, home school, neighborhood /
REQUIRED STEPS FOR CONSIDERATION: 1) At least one mentor must complete the three FIRST Diversity Training program online modules through Schoology and submit the certificates to ORTOP. 2) Mentor who completed certifications will be required to attend a dinner (or online discussion call) along with others receiving the FTFCU funding support.

Carollo: GEOGRAPHY: all of Oregon TYPE: public/private schools, organizations, home school, neighborhood / PRIORITY CONSIDERATION: teams demonstrating financial need not eligible to apply for other awards

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* 10. PENDING SUPPORT FOR 2019: MJ Murdock Charitable Trust - ROOKIE ONLY AWARD - Not a cash award, but Grant Credit on national FIRST Team Profile based on recommendation of ORTOP. $275 towards National Registration and funds (TBD) in credit at the FIRST Storefront for robot parts. Must not have already paid for national registration to be eligible STATUS: Must be a ROOKIE team in 2018-2019. TYPE: public/private schools, organizations, home school, neighborhood. PRIORITY CONSIDERATION: economic hardship, rural, inner city OTHER: Must submit thank you note upon receipt of grant

Yes, our ROOKIE Team(s) would like to be recommended to FIRST for the MJ Murdock Charitable Trust Award

No, we decline to apply for this award.