One Classroom at a Time Application
Award Proposal Form
(One Classroom at a Time)
Home or Cell Number:
Project Description: (use as much or as little space as you need).
Describe the proposed program or project
Identify the needs/problems to be addressed, target population and number of people to be served by the project. Will the project benefit students in years to follow?
Describe, in detail, the project goals and objectives.
Evaluation: Describe how you will show that your project has achieved its goal(s).
Provide a timetable for implementation. (implementation must be within 90 days of receiving the Award)
If this project were to be selected, your classroom/school would also benefit from a CultureAll Workshop (www.cultureall.org) Which type of workshop do you think would best suit your project OR your school and why?
All submissions must come from the Local 5 viewing area in order to be considered.
All decisions announced by Local 5 are final.
Local 5 expressly reserves the right to examine grant awarding's in accordance with these rules within seventy-two (72) hours of grant awarded.
No purchase or donation is required to participate.
Local 5 and sponsors may use grantees' and school name, likeness and any materials collected during the run of the campaign for promotional purposes.
Local 5, sponsors and its employees, participating agencies, and/or organizations and their employees are released from any claims that may arise.
Local 5, sponsors and its employees, participating agencies, other media groups/stations and their families are not eligible for this grant.
Grantee will be notified upon winning how the grant will be distributed.
No transfer or substitution of grant is permitted.
Local 5 management reserves the right to establish additional or change existing rules.
In case of circumstances beyond our control, Local 5 reserves the right to postpone or cancel the campaign.
The form may be submitted by email (attach this word doc) OR U.S. mail to the address listed below.
Mail to: Email to:
Local 5 email@example.com
3903 Westown Parkway
Attn: One Classroom
West Des Moines, IA 50266
Your Signature Date
(This must be received before 5:00pm the first Monday of the month to be considered for that month.)
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