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EXISTING PROGRAM EVALUATION - STAGE 1 APPLICATION
Cover Page Information
Form #1 of 7
1. Title of proposed evaluation (maximum 100 characters with spaces):
2. Principal Investigator information
a) Name:
b) Title:
c) Institution:
d) Address:
e) Phone Number:
f) Email:
3. Office responsible for contracts and grants at sponsoring institution
a) Contact Name:
b) Title:
c) Institution:
d) Address:
e) Phone Number:
f) Email:
4. Date of proposed project
a) Project Start Date (mm/dd/yyyy):
b) Project End Date (mm/dd/yyyy):
5. Total amount requested from BEF (Note: BEF allows only 10% maximum for indirect costs)
a) Total request to the Brady Education Foundation (round off to nearest dollar): $
b) Total request for each year of project as applicable (round off to nearest dollar)
i) Year 1: $
ii) Year 2: $
iii) Year 3: $
6. Total cost of project
a) Is total cost of project greater than amount being requested from BEF? Yes
No
b) If yes, what is the total cost of the project? (round off to nearest dollar) $
7. Other support for this evaluation
a) Current other support for this evaluation
Existing Program Evaluation - Stage 1 Application - Form #1 of 7
1
i) Is other support currently secured for this evaluation? Yes
No
ii) If yes, for each source, provide the following information.
Organization
Start Date of
Support
(maximum 100 characters with spaces)
(mm/dd/yyyy)
End Date of
Support
Total Amount
of Support
(mm/dd/yyyy)
(round off to
nearest dollar)
1.
$
2.
$
3.
$
4.
$
b) Pending other support for this evaluation
i) Are there pending funding requests for this evaluation? Yes
ii) If yes, for each source, provide the following information.
Organization
Date
Start Date
Request
Requested
(maximum 100 characters with spaces)
Submitted (mm/dd/yyyy)
No
End Date
Requested
(mm/dd/yyyy)
(mm/dd/yyyy)
Total
Amount
of
Support
Requested
Expected
Notification
Date
(mm/dd/yyyy)
(round off to
nearest $)
1.
$
2.
$
3.
$
4.
$
c) Plans to submit requests for other support for this evaluation
i) Are there plans to submit for other support for this evaluation? Yes
No
ii) If yes, for each source, provide the following information.
Organization
Expected
Start Date
End Date
Submission
To
Be
To Be
(maximum 100 characters with spaces)
Date
Requested Requested
(mm/dd/yyyy)
(mm/dd/yyyy)
(mm/dd/yyyy)
Total
Amount
of
Support
To Be
Requested
Expected
Notification
Date
(mm/dd/yyyy)
(round off to
nearest $)
1.
$
2.
$
3.
$
When all 7 forms are completed, convert supporting documents and completed forms to .pdf format and submit entire
application as one folder to: [email protected]
Existing Program Evaluation - Stage 1 Application - Form #1 of 7
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