Conrad Toepfer Award Application

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* 1. Applicant First Name

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* 2. Applicant Last Name

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* 3. Email Address

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* 4. Phone Number

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* 5. Project Title

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* 6. Is this a program or project that has been completed, is in progress, or is in the planning stages?

Completed

In progress

Being planned

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* 7. Describe the purpose of the project, including how it benefits middle school students and how it is meaningful to them.

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* 8. Provide a timeline of/for implementation.

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* 9. Describe the project development process, including the role of student participants and other stakeholders involved in the project.

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* 10. Identify the outcomes the project is designed to accomplish.

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* 11. How have/will you measure the effectiveness of the project?

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* 12. If you are requesting a financial support grant, please attach a line-item budget here.

PDF, DOC, DOCX file types only.

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* 13. Describe how the project aligns with the middle school philosophy as outlined in The Successful Middle School: This We Believe/Dr. Toepfer's vision for young adolescents.