Name

First Name

Last Name

Email Address

Date of Application

YYYY

Phone

(###)

###

####

One sentence summary of your proposed Fellowship

Dates of program, course or workship

Location of course, program, workshop

Amount you are requesting

Maximum $4,000

Have you previously received an LEF Fellowship?

Yes, 2016-17

Yes, 2015-16

Yes, 2014-15

Yes, Prior to 2014

#1 Describe the course, workshop, seminar or other professional development opportunity for which you are requesting support. How did you learn of this opportunity?

This may be emailed as a separate document and along with the answers to questions #1-6, with your name and exact same one sentence summary of proposed fellowship in the subject line to: apply@lexedfoundation.org

#2 How this Fellowship will strengthen your professional practice and enhance your students’ learning.

#3 If your application should be considered along with the applications of colleagues, please identify the other members of the group.

Note: Each individual Fellowship applicant must submit a separate, personalized application

#4 If your application should be considered along with the applications of colleagues, please identify the other members of the group (note: Each individual Fellowship applicant must submit a separate, personalized application).

#5 How much funding you are requesting of LEF. Provide a detailed budget including registration fees, travel, accommodations, food, materials, and other anticipated expenses. If this program requires out-of-state or foreign travel, explain/justify the need for travel -- why, for example, this learning/experience cannot occur closer to Lexington.

In figuring travel costs, please note the following: • LEF generally bases the allowance for hotel accommodations on the established government rate for the location, and on double-occupancy rates. If having to pay the difference between the established government rate and the actual cost of accommodations would prevent you from pursuing this opportunity, please state this in your application. • LEF provides a $35 per day food allowance. Please note that Fellowship funds are disbursed on a reimbursement basis.

#6 Do you have any time-sensitive deadlines (e.g., for registration) pertaining to this request? If so, what are they?

One letter of recommendation will be provided from:

Name the person and title who will send a signed electronic letter of recommendation to apply@lexedfoundation.org. Your name must be part of the subject line.

Another letter of recommendation will be sent by:

Name the second person who will email a signed letter of recommendation to apply@lexedfoundation.org

Name of principal, department head or superintendent

This person listed will send the following email to apply@lexedfoundation.org "I certify that the request by _________ for funding an LEF Fellowship is not covered by the school system's operating budget."

I am sending additional supporting documentation as part of my application

Link to website about the program

Program description document (pdf)

No extra materials

Yes, I have read and understand:

Checking each box below certifies your response.

The application requirements

The grantee recipient responsibilities

Signature

This entry signifies the signature of the applicant.

Thank you! Your Fellowship Grant Application was received and LEF will be in touch with you in two-four weeks. If you have questions in the meantime, please contact your LEF liaison.