2. Date:*
4. Title of Project:*
6. Contact Person:*
8. Daytime Phone #:*
10. E-mail address:*
12. School or Site Name:*
14. Grade(s) impacted:*
16. Expected Start Date:*
18. Expected Completion Date:*
20. Select a PIE Level: (see Grant Criteria)*

    1. Apple
    2. Cherry
    3. Slice
    4. Bite
22. Number of students enrolled at School:*
24. Number of students directly impacted by this proposal:*
26. Amount Requesting:*
28. Project Budget: Attach a Budget of expensed and income (Break down your budget by Category, i.e. by prizes, materials, food, including total and attach)

    *
30. Subject Category (choose all that apply):*

    1. Bilingual Education
    2. Career Development
    3. Character Counts
    4. Conflict Resolution, Mediations Peer Counseling
    5. Early Childhood Health and Fitness
    6. English Language Learner (ELL)
    7. Fine Arts
    8. Incentive Program
    9. Reading/Language Development
    10. Education Plan for Student Success (EPSS)
    11. Language Development
    12. Literacy
    13. Local and Regional History and Culture
    14. Science and Math
    15. Special Education
    16. Telecommunications/ Technology
32. Describe how this project supports the selected category(s):*
34. One-sentence project summary:*
36. How will you implement this project? (Time line, activities, expected results, etc):*
38. 
    NOTE: Do not forget, each Grant must have an accountability report electronically submitted to Los Lunas Partners in Education, via our website, www.loslunasnm.gov/PIE, within 60 days after grant is awarded in order to apply for any future Grants with Los Lunas Partners in Education. The report must have receipts of all expenses, and a detailed project report on how the students benefited from the project and the final outcome of the project. Any funds in excess of $100 are to be returned to LL PIE. Funds under $100 may be used at your school for students. Equipment purchased with LL PIE funds become the property of the Los Lunas School District. If project is not able to be implemented 100% of the funds must be returned to LL PIE with an explanation to why the project was not implemented.
40. Principal Name:*
42. Principal Email Address:*
44. **Los Lunas Partners in Education will send a copy of your Grant Application to the Principal**
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field