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Engineers Week Outreach Grant Application

Name of Outreach Event *

Applicant Information

Contact First Name: *

Contact Last Name: *

Organization: *

Street: *

City: *

State: *

Zip code: *

Country: *

Phone: *

Email: *

Are you a member of an engineering society? *

Please Tell Us About Your Outreach Event:

Please provide a general description of your outreach event: *

What are the goals and objectives of your program and how will you measure them? *

How is this event or program connected to Engineers Week and its goals? *

Who is the target audience? Please include anticipated numbers, ages and demographics. *

Where will your event take place?

What is your total project budget? Please list any additional sources of revenue. (Please note you will need to notify us if things change). *

How much are you requesting? *

Is this a new program/project? *

If no, please explain how this grant will add to its success:

Project/program start date: *

Project/program completion date: *

Engineers Week Outreach Grants