Application 1 STEP 1.signup & contact info2 STEP 2.about your project3 STEP 3.project costs4 STEP 4.about your organization5 STEP 5.confirmationContact Information*Address*Contact Person*Contact Email* Telephone*Organization WebsiteOur Organization is applying for:*Conventional GrantSTEM GrantIf you would like to go back and reread the Guidelines please Click HereSEVENTH-DAY ADVENTIST ELEMENTARY AND SECONDARY SCHOOLS WITHIN THE NORTH AMERICAN DIVISION OF SDAAfter having carefully read the 2019 Versafund Guidelines we are applying for one of the Educational Technology Category Fixed Grants.Please Check the Fixed amount/school that you are applying for:40 at $5,000 For small schools with three classrooms or less60 at $10,000 For larger schools with four or more classrooms20 at $10,000 For senior academiesAbout Your Project :Describe the proposed project, including how The Versafund monies would be used, timetables involved, and expected outcomes and benefits. Explain the SUSTAINABILITY of your project. In other words, will The Versafund Grant allow you to continue on into the future, successfully? Do this in a summary statement of no more than 350 words. You may provide further backup information on additional sheets, but we do ask you to provide the above requested summary overview statement!About Your Project :Describe the proposed project, including how The Versafund monies would be used, and the type of technology you will be utilizing within your school. Make sure that you can fulfill each of the Qualifications that were listed on the Guidelines Page for Educational Technology Category Grants. Do this in a summary statement of no more than 350 words.*SummaryProject Costs / ExpensesItemize below:Project Costs Description*$* Project Costs Description*$* Project Costs Description$ Project Costs Description$ Project Costs Description$ Project Costs Description$ Total: $0.00 Project IncomeItemize below:Project Income Description*$*Project Income Description*$*Project Income Description$Project Income Description$Total:Amount Requested from The Versafund:Other Sources of Income or Matching funds for your Project: Describe other sources of income, or provide information regarding other organizations assisting with matching funds for your project.Other Sources of Income or Matching funds for your Project:Is there any other information that you wish to provide?Information about The Organization Itemize below:Year Established*Briefly describe your organization's history and purpose:*List any credentials, accreditations or affiliations your organization belongs to:Please attach a list of the members of your governing board: Drop files here or Accepted file types: pdf, png, jpg, doc, xls, xlsx, doc, zip, ppt, jpeg.Warning: Upload file size should not be more than 10MB.Is your organization a tax-exempt corporation?YesNoOfficial Schools within the K-12 system of the North American Division of SDA, are covered by the Corporate Church Exemption:Financial DataPlease attach a copy of your latest annual financial statement. Drop files here or Accepted file types: pdf, png, jpg, doc, xls, xlsx, docx, zip, ppt, jpeg.Warning: Upload file size should not be more than 10MB.Are you willing to provide a full financial accounting of how The Versafund monies were used, and to be audited, if requested?YesNoTechnology PlanPlease attach a copy of your school’s technology plan if applying for a STEM grant.Accepted file types: pdf, png, jpg, doc, xls, xlsx, docx, zip, ppt, jpeg.Warning: Upload file size should not be more than 10MB.Only fill out signature when you are ready to complete and submit your application.Digital Signature*Title*Date* This application form and supportive materials must be received by December 31, 2019. If you have questions or desire additional information, please contact us at:The Versafund 4097 Trail Creek Road, Suite B Riverside, California 92505 (951) 343-5800 versacare@versafund.orgFile
