1. Welcome, Nicole Wingate!To return to this application page, bookmark: http://www.cybergrants.com/dollar_general/backtoschool<br />The organization you are currently associated with is Wayne County High School.<br />If you work with multiple organizations, click here to add a new organization to your account.<br />Dollar General’s commitment to literacy began with J.L. Turner, co-founder of Dollar General. With only a third grade education, J.L. was able to overcome tremendous odds and launch a successful retail business. As an extension of Dollar General’s corporate commitment to literacy, the Dollar General Literacy Foundation was established in 1993 to help increase the functional literacy of adults, families and children. Funding Focus The Dollar General Back to School Grants provide funding to assist school libraries or media centers in meeting some of the financial challenges they face in the following areas:<br />Implementing new or expanding existing literacy programs<br />Purchasing new technology or equipment to support literacy initiatives<br />Purchasing materials or software for literacy programs<br />Timeline: <br />May 21, 2010August 20, 2010May 28, 2011Deadline to applyGrants announcedImpact reports due<br />Reporting Requirements: Schools receiving funds from the Dollar General Literacy Foundation are required to provide an impact report detailing the progress that has been made toward the objectives outlined in the approved proposal. Schools will be required to report the number of students served, detailed budget information and student education gains if applicable. Schools that do not comply with reporting requirements will not be eligible for future funding from the Dollar General Literacy Foundation. You will receive e-mail notification once your Back to School impact report is available for completion on line. Questions regarding our charitable practices? Contact the Dollar General Literacy Foundation at (615) 855-5201. Questions regarding technical support or assistance for the on-line application? If you have technical questions regarding this application, use the link located at the bottom of every page to contact our support team. Application Preview<br />We recommend that you familiarize yourself with the online application before you begin.<br />The Apply Online grant application consists of eight main sections, each of which must be completed for your proposal to be considered.<br />Contact information pertaining to your school.<br />School information pertaining to your school.<br />Overview of the proposal your school is submitting for approval.<br />Project Purpose and Outcomes.<br />Project Design and Evaluation.<br />Budget Information.<br />USA Patriot Act Counter-terrorism Compliance.<br />Approval of Principal.<br />Once completed, all applications created in Apply Online are immediately submitted to Dollar General.<br />To Start Your Application:<br />To create a new application, click the quot;
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link at the bottom of this page.<br />You may also save your applications now and return to work on them later. To continue work on an unsubmitted application, log in at the URL below and click the quot;
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link next to the application's Project Title. You may wish to bookmark this link for future reference.<br />http://www.cybergrants.com/dollar_general/ backtoschool<br />Contact InformationPlease check the appropriate contact match box(es) for this grant application. All correspondence related to this application will be mailed to the selected recipient(s).Match: Click to associate this individual with this application.Name: NICOLE WINGATEPhone: 912-294-1058E-mail: nicolewingate@gmail.comSchool InformationSchool Name (required) Please enter your school's legal name. AKA Name Please enter your AKA Name. Address (required) Please enter your school's address. City (required) Please enter your school's city. State (required) Please enter your school's state. Zip (required) Please enter your school's zip code. Telephone Please enter your school's telephone number. Fax Please enter your Fax number. Nearest Dollar General Store (required) Please enter the distance in miles to the nearest Dollar General Store. School must be located in Dollar General's 35-state operating territory and must be within 20 miles of the nearest Dollar General Store. To determine the location of the nearest Dollar General store, visit our store locator page. IRS 501(c)3 Determination Letter If applicable, please upload your organization's 501(c)3 determination letter. HYPERLINK quot;
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Upload File (Click for instructions)How long has your school been in existence? (required) Type of School (required) Grade levels served (required) OverviewProject Title (required) Please enter the project title. Requested Cash Amount (required) Please enter the amount you are requesting from the Dollar General Literacy Foundation for this project ($5,000 maximum). Number of individuals to be served by funding from this Back to School application(required) Projected Ethnicity Served (required) Based upon the students that you currently serve, please estimate these numbers. African American Asian/Pacific Islander Caucasian Hispanic Native American Multi-Racial417.00 TotalProject Target Audience (required) Have you received previous funding from the Dollar General Literacy Foundation?(required) If Yes, what was the grant amount and when did you receive it? Is this the first year of the project that you are requesting funding for? (required) If it is not the first year for this project, then how many individuals were served by this Back to School project last year? Needs Statement (required) Please provide a brief summary of the limitations and needs of your library or media center. Project Purpose and OutcomesWhat is the unemployment rate? (required) 2000 character maximumWhat is the high school graduation rate? (required) 2000 character maximumWhat is the drop-out rate? (required) 2000 character maximumWhat is the poverty level in the geographical area served? (required) 2000 character maximumWhat is the free/reduced lunch rate at your school? (required) Project/Program Purpose (required) Please describe the project goals and objectives in terms of measurable outcomes for the target population. Include the number of people to be served and the area in which services will be provided. Outcomes should include the actual numbers, not percentages, of individuals who will be served in order to attain your goals. 2000 character maximumProject Design and EvaluationProject/Program Design (required) Summarize the design of the project/program components and how it will meet the stated purpose and objectives. 2000 character maximumTimeline (required) State the timeline for accomplishing stated outcomes. The timeline should include project duration and number of weekly instructional hours to be provided per student. 2000 character maximumMeasurable Results (required) Describe the specific, measurable results that indicate the improvement you expect to achieve by the end of the funding period. Avoid using ambiguous phrases such as “satisfied, improved, enhanced, etc.” to define success. Use quantitative, not qualitative data to report results. Example: Twenty students will use the bilingual books during weekly instruction with the reading specialist. 2000 character maximumAssessment Methods (required) Describe the methods that will be used to assess the effectiveness of the books, computers or software that will be added to your library or media center. Describe the measurement tool that will be used to track education gains and the frequency of measurement. 2000 character maximumAvailable Technology (required) List the technology available and utilized in your library or media center. If this question does not apply please type in None. 2000 character maximumComputers and Software (required) List the number of computers as well as the software resources that will be used during direct instruction. If this question does not apply please type in None. 2000 character maximumBudget InformationPlease complete the Budget Allocations section of this page specific to the project you are requesting Dollar General Literacy Foundation funds.The budget should assume a grant disbursement schedule of 100% at project start.Budget Allocations (required) Please complete the following Budget Allocations. You will need to provide justification for the budgeted amounts in the budget narrative question. Books BK - DGLF Support$0.00 TotalComputer - $4,893.00 CO - DGLF Request$4,893.00 TotalInstructional Materials IM - DGLF Request$0.00 TotalSoftware SO - DGLF Support$0.00 TotalTotal Budget Allocations : $4,893.00Budget Narrative (required) USA Patriot Act Counter-terrorism ComplianceIn compliance with the spirit and intent of the USA Patriot Act and other counter-terrorism laws, the Dollar General Literacy Foundation requests that each funded agency/organization complete the following questionnaire. * In this form, “material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, personnel, transportation, and other physical assets, except medicine or religious materials.SCHOOL NAME: (required) Check the appropriate box to indicate your compliance with each of the following:Patriot Act - Question 1 (required) This school is not on any federal terrorism “watch lists”, including the list in Executive Order 13224, the master list of specially designated nationals and blocked persons maintained by the Treasury Department, and the list of Foreign Terrorist Organizations maintained by the State Department. Agree Disagree Patriot Act - Question 2 (required) This school does not, will not, and has not knowingly provided financial, technical, in-kind or other material support or resources* to any individual or entity that is a terrorist or terrorist organization, or that supports or funds terrorism. Agree Disagree Patriot Act - Question 3 (required) This school does not, will not, and has not knowingly provided or collected funds or provided material support or resources with the intention that such funds or material support or resources be used to carry out acts of terrorism. Agree Disagree Patriot Act - Question 4 (required) This school does not, will not, and has not knowingly provided financial or material support or resources to any entity that has knowingly concealed the source of funds used to carry out terrorism or to support Foreign Terrorist Organizations. Agree Disagree Patriot Act - Question 5 (required) This school does not re-grant to organizations, individuals, programs and/or projects outside of the United States of America without compliance with IRS guidelines. Agree Disagree Patriot Act - Question 6 (required) This school takes reasonable, affirmative steps to ensure that any funds or resources distributed or processed do not fund terrorism or terrorist organizations. Agree Disagree I certify on behalf of the school listed above that the foregoing is true. (required) I Agree Approval of PrincipalName of Principal (required) Submission Approval (required) By checking the box, you certify that the submission of this application to the Dollar General Literacy Foundation is approved by the individual indicated above. I Agree <br />