Youth Service America

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Preview Form This is an example of the application questions with which you will be presented. It is recommended that you compose the answers to the paragraph questions in a word processing program and then cut and paste that text into the online application. Primary Contact

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Please include the contact information for the person who will serve as the primary contact person for the Sodexo School Engagement Grants program at your school. Your primary contact should be the teacher who will be most directly involved with presenting the Sodexo School Engagement Grant program to students. Please note: We will need to communicate with you in the summer of 2011. Be sure to provide contact information where we can reach you during the summer. To add a new contact, click the "Create New" button.
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*Salutation (Text; 100 character maximum) *Last Name (Text; 40 character maximum) *First Name (Text; 40 character maximum) *Mailing Address (Text; 100 character maximum) *City (Text; 50 character maximum) *State (Single-Select List) (Not Applicable) Alabama Alaska American Samoa Arizona Arkansas Armed Forces Africa/Canada/Europe/Middle East Armed Forces Americas (except Canada)

Please enter the primary contact person's salutation (e.g., Mr., Miss, Ms.).
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Please enter the primary contact person's last name.

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Please enter the primary contact person's first name.

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Please enter the primary contact person's mailing address.

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Please enter the primary contact person's city.

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Please select the primary contact person's state.

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Youth Service America

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Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming *Zip (Text; 20 character maximum) *Primary Telephone (Text; 30 character maximum)
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Please enter the primary contact person's zip.

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Please enter the primary contact person's primary telephone (area code and number). This may be the school's phone number.

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*Alternate Telephone (Text; 500 character maximum)

Please enter the primary contact person's alternate telephone (area code and phone number) where s/he can be reached during the summer months.
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*E-mail Address (Text; 100 character maximum) *Alternate E-mail Address (Text; 500 character maximum) *Primary Contact Grade Level(s) (Multi-Select List) K 1 2 3 4 5 6 7 8 9 10 11 12

Please enter the primary contact person's e-mail address. This may be a school e-mail address.
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Please enter the primary contact person's e-mail address where s/he may be reached during the summer months.

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Which grade level(s) does the primary contact teach or instruct? Please select all that apply.

School

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*Name of school (Text; 255 character maximum) *Mailing Address (Text; 100 character maximum) *City (Text; 50 character maximum) State (Single-Select List) (Not Applicable) Alabama Alaska American Samoa Arizona Arkansas Armed Forces Africa/Canada/Europe/Middle East Armed Forces Americas (except Canada) Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho
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Please enter the primary applicants school name.

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Please enter the school mailing address.

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Please enter the city where the school is located.

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Please select the state where the school is located.

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Youth Service America

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Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming *Zip (Text; 20 character maximum) *Grade Levels (Text; 500 character maximum) *Administration Contact (Text; 500 character maximum)
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Please enter the school's mailing zip.

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Please provide the grade range of the school.

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Please enter the name and title of the school administrator who will sign the MOU for the schools participation in the program.
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*School Administrator Support (Yes/No)

Has the school administration endorsed the participation of the applicant and at least 20 students in the Sodexo School Engagement grant? Students

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Youth Service America

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*Number of Service-Learners (Number; 7 digit maximum)

How many students will be involved continually and regularly in your Sodexo School Engagement Semester of Service? Please note: you will be required to include a minimum of 20 students on a continual and regular basis.
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*Free/Reduced Lunch (Number; 4 digit maximum)

What percentage of the school's total student body is eligible for free/reduced price lunch?
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*Diversity (Paragraph; 2000 character maximum)

How will you intentionally target and engage a diverse group of students through outreach to youth who are not traditionally asked to serve? See YSAs Effective Practices Guide for Engaging At-Risk Youth in Service here. Service-Learning

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Service-learning is a teaching and learning strategy that combines meaningful service to the community with acquisition of academic learning and skills. Schools and organizations use service-learning as a strategy to support student learning, academic achievement and workplace readiness, as youth address real problems and improve communities. The Sodexo School Engagement Grants program incorporates service-learning into a Semester of Service framework that engages students in a minimum of 70 hours of service and learning over a period of at least 10 -14 weeks. It is expected that applicants will refer to Youth Service America's Semester of Service Strategy Guide when completing the application. *School Service-Learning Requirement (Single-Select List) No Yes *District Service-Learning Requirement (Yes/No) *Teacher Service-Learning Experience (Paragraph; 2000 character maximum) *Subject Areas (Multi-Select List) Civics Language Arts Social Studies Other (please describe) Subject Areas - Other (Text; 500 character maximum) Statement of Purpose (Paragraph; 2000 character maximum)

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Is there a service-learning requirement in the school?

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Is there a service-learning requirement in the district?

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Do you have prior experience with service-learning? If yes, please share examples of service-learning projects you have implemented with students .
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Please select the subject area(s) that will be the focus of your Sodexo School Engagement Grants program. Please select all that apply by holding the Ctrl key.
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If you selected other, please describe.

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Please describe your reasons for applying to the Sodexo School Engagement Grants program. In your response, include creative elements you will include in your program.
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*Proposed Service-Learning Program (Long Paragraph)

Please describe how you will plan in incorporate your Sodexo School Engagement Semester of Service into your Civics, Language Arts and/or Social Studies curriculum (or other academic areas) through a service-learning model over a semester. Please be specific in identifying which

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required state or national standards this will meet. We are looking for a creative and intentional approach involving the application of service-learning as a teaching and learning strategy for primarily Civics, Language Arts and/or Social Studies content areas. Please describe your proposed program, giving as much detail as you think necessary to indicate the following: How will your program engage students in identifying and impacting childhood hunger in your community? How will your program incorporate Civics, Language Arts and/or Social Studies (or other subject) content learning and specific state academic standards? How will your program have a strong impact on the students involved? How will your program be a sustained servicelearning effort over a 10 -14 week period (September 6, 2011, through Hunger & Homelessness Week, November 14 20, 2011)?
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*Student Achievement (Paragraph; 2000 character maximum)

What are your goals for student achievement? How will you measure success? Please note that through this program you and your students will be engaged in a professionally developed evaluation including pre and post testing.
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*Youth Voice (Paragraph; 2000 character maximum)

YSA and Sodexo promote the inclusion of youth voice- as intentional opportunities for students themselves to lead and make decisions that inform and guide their service-learning projects. How will you include youth voice in your process?
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*Workforce Readiness Skills (Paragraph; 2000 character maximum)

What workforce readiness skills will students gain from participating in this program? Examples of workforce readiness skills include the following: personal management, positive work ethic, teamwork, collaboration, critical thinking, problem solving, effective communication, career development and employment foundations.
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*Stronger Communities (Paragraph; 2000 character maximum)

Please describe the anticipated impact on the issue of childhood hunger in your community (e.g., lbs of food collected, # of students receiving meals who didnt before, # of children served a meal at a shelter, etc). What do you expect will change in your community as a result of your project? Note: this is not the impact of the program on the participating students, but instead the impact on the community and on the problem addressed.
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*Community Partner (Paragraph; 2000 character maximum)

A requirement of this program is the development of a partnership with a community partner organization already focused on childhood hunger (e.g., the local Food Bank, etc.). The community partner should be able to help you understand specific issues related to childhood hunger including the extent of the problem in your community, and how your project can have the most impact. Who is your community partner for this project and how do you anticipate working with them during your project?
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*Additional Community Partners (Paragraph; 2000 character maximum)

Provide a list of additional partners that you could engage to implement the service-learning program. How can

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community partners contribute to the identification, development and implementation of your proposed servicelearning activities? Possible contributions could be additional funds, in-kind contributions, trainers and expertise, space, transportation, or technology.
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Sodexo Employee Help (Paragraph; 2000 character maximum)

Sodexo is a company that provides food and other services to many different locations and lots of different people. We encourage you to reach out to them and ask them to help with your project. Sodexo employees may be working in your cafeteria, local hospital or many other places. Check out the Sodexo website (http://www.sodexousa.com/usen/environments /environments.asp) to see the different types of places Sodexo employees work. Where might you be able to get some help? If so, what will Sodexo Employees be doing to help you with your project? If you were not able to get in contact with Sodexo employees before submitting your application will you continue to try? What would you have them do to help? Budget

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The budget for the grant, totaling up to $5,000, should include line items in the following categories: Professional development (includes teacher training, professional learning communities, travel and substitute fees as well as expenses for travel and participation for one staff member to attend a training in late Spring (May/June) and attendance at the Youth Service Institute in Philadelphia, PA, October 26-28, 2011); Program expenses (includes materials, transportation and marketing); Demonstration and celebration (includes production costs for video and photos, as well as limited expenditures on food, t-shirts and other recognition items). Your budget must include up to $1,500 for travel, lodging and registration fees for one staff member (this should be the primary contact) to attend the two training sessions identified above.

Budget Guidelines
Grant funds should overwhelmingly be used for the original purpose outlined in your application. Please download the following to guide your development of your budget: Budget Template Expenses MAY NOT include: Honoraria, salaries or stipends for specialists/associates except as reimbursement for transportation, meals, and other reasonable out-of-pocket expenses directly related to program participation. Please check with YSA for clarification on what is considered a reasonable expense; Financial gifts or donations, even to causes associated with student projects; The use of "miscellaneous expenses" without explanation; Long-range program expenses/ overhead that are not related to the proposed project. Expenses MAY include: Local transportation for youth doing service and participating in service-learning related field trips; Administrative expenses such as communication (phone, fax, e-mail, postage), copying and print services that are directly related to service project; Materials and equipment (especially scientific) needed for service project (seeds, plants, trash bags, paper, art supplies, tools, etc.); The total expenditure (excluding in-kind) for recognition and celebration items should not exceed $500: 1. Refreshments that are integral to the project or are part of a program, training or demonstration event. Every effort should be made to secure funding from other sources for larger food costs and celebration activities. 2. T-shirts, refreshments, certificates, plaques, etc. are considered recognition and celebration items. Minor expenses for identification of service-learning participants or recognition of excellent or outstanding

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participant service, such as the Presidents Volunteer Service Awards are allowable. Please note that YSA will be happy to provide certificates and other recognition items free of charge.
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*Budget (File Upload; 1,048,576 byte limit)

Follow the budget guidelines above and use the Budget Template to guide your development of your budget. Need Support?

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