Hewlett Fund Application Form

1. Project Title:


2. List the names, addresses and phone numbers of the applicants:





3. Amount Requested:


4. Grant Period:


5. Signature of applicant: __________________________________________

Date: __________



6. Statement of recognition of support from Program Director/Department Chair: I agree that this innovation is important to my department/program. Assuming that the project is successful, I agree to provide teaching support for this course to continue in the curriculum. ____________________________



7. Abstract:












8. Attach a brief description of the project. Include details about the project, how it relates to the current curriculum, names of specific courses involved and their enrollments, and how the project is innovative at Northwestern and will improve instruction and benefit students.


9. Describe any prior funding this project has received. What was accomplished with prior funding?


10. Describe any current funding this project is receiving.


11. Describe plans for further funding requests or plans to request matching funds.


12. What other courses at Northwestern can make use of this innovation?


13. To what extent does this project take advantage of existing resources and facilities?


14. Does this project include any computer or other hardware purchases? What are the plans for disbursal of this equipment after the project is finished?


15. Attach a budget.

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