Grant Application

Thank you for applying for an EPAK grant. Please review the parameters for the current semester by reading the For Teachers page and FAQs before continuing.

If you need help at any time please contact allocations@epak.org.

Registration and School Information
Name*
First Last
School*
Position*
Please describe your "Other Student-Facing Position" (eligibility subject to approval)
Grade Level*
Other/Multiple Grade Level

please clarify
Email*
Phone*

We will only call or text if we cannot reach you by email.
I prefer to receive grant funds by:*
- Electronic transfer to my bank account (account info must be provided to the EPAK Treasurer)
- Paper check by U.S. Mail to the address below
Account Information
To send an electronic transfer, the EPAK Treasurer will need your bank name, the name on the account and the numbers across the bottom of one of your checks. Enter the info here or contact Ellen by Email: ellen@epak.org (may send a photo of a check) or Phone: 650-704-3666.
Bank Name on the Account Routing Number Account Number
Mailing Address for check*
Checks take 7-10 days and will arrive in an unmarked plain white envelope. Please watch your mail carefully if you choose this option.

Street Address Address Line 2 City State ZIP Code
Project Description/Objective*
Provide a clear description of how your project will enhance student learning in the classroom. (between 250 and 1,000 words)
Budget
Add as many lines as required

Line Items

Vendor	Item Description	Quantity	Cost	Sub-total	Tax	Shipping	Total	Actions

There are no Line items.

Total budget
The maximum grant amount is $750
Disclosures
To maintain our tax-exempt status EPAK is required to keep records of your relationship to EPAK board members, officers or donors.
I am related to EPAK in this way:*
- I am an EPAK board member
- I am related to an EPAK board member, officer, or donor
- None of the above
Certification & Agreement
I certify that I am directly responsible for the application and use of these funds. If I am awarded this grant, I agree to:
1. Use these funds for the purpose I have stated.
2. Request permission in writing before making any changes.
3. Submit a post-project report along with scans of original receipts by December 15 (Fall) or June 15 (Spring).
4. Return unused funds to EPAK.
5. Leave any books, equipment, and materials purchased with these funds with my school or institution if I leave so that the children will continue to have the benefit of this grant.
6. Not apply for future grants until prior post project reports have been approved.
7. I have read the grant parameters on the EPAK website and agree to abide by them when I apply for fall and spring grants.
Agreement*
- I agree to these terms
Comments
This field is for validation purposes and should be left unchanged.

Grant Application

Grant Application

Registration and School Information

Budget

Disclosures

Certification & Agreement

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