Application Form:
Local Section Diversity, Inclusion, & Respect (DI&R) Grant

Application Deadline: November 08, 2020, 11:59 pm ET

Select Your Local Section: *

Today's Date: * +

Project Coordinator Information:

Full Name: *

Address: *

Tel: *

Email: *

Grant Information:

Title of Project: *

Brief Description: *

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Name of Current Section Chair: *

Grant Letters of Support:

Submitting a letter of support from the active local section chair is required. If one is not provided through this application, you will need to send it via an email attachment to lsac@acs.org no later than the posted deadline. (If the Section Chair is the Project Coordinator, a member of the Executive Committee must submit the support letter.)

Upload Local Section's letter of support here (acceptable formats: .pdf, .doc, .docx).

Grant Co-sponsors:

Submitting a letter of support from co-sponsors is required, only if the local section is partnering with one (or more) groups for this grant. If one is not provided through this application, you will need to send it via an email attachment to lsac@acs.org no later than the posted submission deadline.

Which groups are co-sponsors? *

Specify partnership(s): *

0/200 characters

Upload co-sponsor's letter(s) of support here (acceptable formats: .pdf, .doc, .docx). For multiple co-sponsors, please combine support letters into one file and upload it.

Full Description of Project or Event:

What are the project's goals/objectives? *

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Provide a rationale for how your Local Section will use this grant funding to promote and/or advance diversity, inclusion, and respect iniatives and activities. *

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Identify target audience(s) and estimate the number of people to be reached. Do you anticipate having adequate support from section members to ensure the project's success? *

0/1000 characters

What impact will this event have on future Local Section activities and events? *

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What is the project's plan of action? Please include probable date(s). *

0/1000 characters

Budget:

Please complete the budget table below or attach a budget spreadsheet (option below) of expenses with brief justifications. LSAC can award a maximum of $2,000 (indicate source of additional funds if budget exceeds $2,000). Some items that cannot receive funding are honoraria; alcoholic beverages; full meals for local section members; or passthrough donations to other individuals or organizations. Local Sections will be permitted to use funds to encourage registrations using gift cards as a small reward for participation. Consulting fees will also be allowed, however, consultants are not allowed to be members of ACS.

Resource these sample budgets (A and B) as models for how to craft your project's budget. Reviewers are looking for specificity.

NOTE: for this form to calculate correctly, enter dollar amounts without commas and without dollar signs.

Item:

Expense:

Justification:

Item:

Expense:

Justification:

Item:

Expense:

Justification:

Item:

Expense:

Justification:

Item:

Expense:

Justification:

Item:

Expense:

Justification:

Additional funds requested from other sources:

Justification:

Project Total:

$0.00

Total Requested from LSAC:

$0.00

If the spaces provided above are insufficient, please upload a detailed budget spreadsheet to this application.

Evaluation Plan:

What tools will you use to measure success of event (i.e., surveys)? *

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Questions? Contact lsac@acs.org.

Application Form:Local Section Diversity, Inclusion, & Respect (DI&R) Grant

Project Coordinator Information:

Grant Information:

Grant Letters of Support:

Full Description of Project or Event:

Budget:

Evaluation Plan:

Application Form:
Local Section Diversity, Inclusion, & Respect (DI&R) Grant