(Applications must use this form and be completed electronically or typed)

Date: Applicant Organization Name (as shown on 501 (c) (3) letter): Mailing Address: City: Executive Director(s): Program Director: __ Program Director(s) email address: Program Title: Program Summary (25 words or less): Phone: Ext: State: Zip:

_____________________________________________________________________________________ When will the Program take place? Start: Please note funding will not be distributed until after October 1, 2007. End:

Amount requested from US Airways Education Foundation (not to exceed $5,000) Total funding required for this Program: $ Total annual organizational budget (not applicable for public schools): $ Percentage of total Program budget allocated to administrative costs: Do you receive funding from a federated campaign (i.e. United Way or United Campaigns)? Yes If so, what percentage of your annual operating budget do you receive from a federated campaign: Does a portion of your fundraising for this program go to your national organization? Yes If so, how what percentage? Geographic area to be served by this Program: Description of population segment to be served: Estimated number to be served: Has your organization received funding from the US Airways Education Foundation (formerly the America
West Airlines Education Foundation) in the past? Yes

% No %

No %


If so, when?


Title of Program funded and amount: _____________________________________________________________________________

Please answer the following questions (in 500 words or less) and use additional pages as necessary: Describe your organization and the community it serves:


Describe the educational program to be funded with support from the US Airways Education Foundation, Inc.:

______________________________________________________________________________ Specifically, how will money granted by the US Airways Education Foundation be used? State the specific goals you wish to achieve and describe the activities that will take place to reach those goals:

______________________________________________________________________________ You will be required to provide a follow-up report. How will you evaluate and measure the impact of the grant and how will the grant provide visibility to US Airways?


Expenses Personnel/Staff (include salary and benefits) a) Administrative b) Teaching (including aides) Total Personnel/Staff Outside Fees and Services a) Consultants b) Other Total Other Fees and Services Remaining Operating Expenses a) Supplies/Materials b) Other (please list) $ $ $ $ $ Total Remaining Operating Expenses TOTAL CASH EXPENSES ADDITIONAL PROGRAM FUNDING/SUPPORT $ $ $ $

Budget for the Program

Portion of budget to be supported by Education Foundation Grant $ $

$ $ $ $ $ $ $ $ $ $ $



$ $

List principal sources and amounts of on-going annual support already secured for this educational program:

a) b) c)

$ $ $

THE FOLLOWING INFORMATION MUST BE INCLUDED TO COMPLETE THE GRANT APPLICATIONS. INCOMPLETE APPLICATIONS WILL NOT BE REVIEWED. 501 (c) (3) tax exempt letter Detailed operational budget outlining all sources of financial support Board of Directors list, including business affiliations and addresses _________________________ Executive Director’s Signature Date