DATE:_______________
Name: _______________________________________________________________
Organization: _______________________________________________________________
Department: ______________________________________________________________
Address of Organization:
______________________________________________________________
______________________________________________________________
County: ____________ State:________________________________ Zip Code:____________
Name and Title of Official Certifying Organizational Compliance with the Grant:
Signature ______________________________________________________________
Name/Title (print or type) _______________________________________________________
ACS Member or Affiliate? ___________
How many individuals will benefit from this grant if your proposal is funded? ___________
Grant criteria: Funds are to be used to improve chemical education in the area served by the Cincinnati Section of the American Chemical Society.
Grant Proposal: The proposal should contain 300-500 words, double-spaced on official letterhead. It should describe the objective(s) of the project, how the project will be carried out, how the project would improve chemical education, how the program fits into the education program (if the applicant is from a school) and whom would benefit. Also, the proposal should contain a detailed budget which outlines expenditures, the amount being requested from the Educational Grant and the amount being requested from other sources.
Send five (5) copies of the application and the proposal to:
Ginger Tannenbaum
Fairfield High School
8800 Holden Blvd.
Fairfield, OH 45014
Reports: Grant recipients are required to submit a report to the Committee within one year from the time of notification of the award. The report will include an outline of how the funds were used, what had been purchased, if anything, with the funds and what benefits have been derived thus far from the use of the funds.
Acknowledgment: It is requested that the major instruments purchased with the use of these funds be tagged with the following acknowledgment:
"This equipment was purchased (in part) with an Educational Grant from the Cincinnati Section of the American Chemical Society."