Use the text fields below to enter information about your proposed Spark project and the file upload fields to add your application attachments.

All fields marked with an asterisk (*) are required.

Please assure that you have entered all information completely and accurately before submitting your application.

Micro Spark Application Cover Sheet

1. Project Information

Name of Project*

Applying Organization(s) (if applicable)

2a. Contact Information for Lead Project Manager

Full Name
TitleFirst*MiddleLast*Suffix
---Mr.Ms.Dr.Rev.Prof.Hon.

Job Title

Company/Organization/Affiliation

Mailing Address (Street 1*, Street 2, City*, State*, ZIP Code*)


PA - PennsylvaniaAL - AlabamaAK - AlaskaAZ - Arizona AR - ArkansasCA - California CO - Colorado CT - ConnecticutDE - DelawareDC - District of ColumbiaFL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVA - Virginia WA - WashingtonWV - West VirginiaWI - WisconsinWY - Wyoming

Mobile Phone (###-###-####)
--

Business Phone (###-###-#### x ####)
-- x

Email Address*

Briefly describe this manager's role with the proposed project

(if applicable)
2b. Contact Information for Project Manager #2

Full Name
TitleFirstMiddleLastSuffix
---Mr.Ms.Dr.Rev.Prof.Hon.

Job Title

Company/Organization/Affiliation

Mailing Address (Street 1, Street 2, City, State, ZIP Code)


PA - PennsylvaniaAL - AlabamaAK - AlaskaAZ - Arizona AR - ArkansasCA - California CO - Colorado CT - ConnecticutDE - DelawareDC - District of ColumbiaFL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVA - Virginia WA - WashingtonWV - West VirginiaWI - WisconsinWY - Wyoming

Mobile Phone (###-###-####)
--

Business Phone (###-###-#### x ####)
-- x

Email Address

Briefly describe this manager's role with the proposed project

(if applicable)
2c. Contact Information for Project Manager #3

Full Name
TitleFirstMiddleLastSuffix
---Mr.Ms.Dr.Rev.Prof.Hon.

Job Title

Company/Organization/Affiliation

Mailing Address (Street 1, Street 2, City, State, ZIP Code)


PA - PennsylvaniaAL - AlabamaAK - AlaskaAZ - Arizona AR - ArkansasCA - California CO - Colorado CT - ConnecticutDE - DelawareDC - District of ColumbiaFL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVA - Virginia WA - WashingtonWV - West VirginiaWI - WisconsinWY - Wyoming

Mobile Phone (###-###-####)
--

Business Phone (###-###-#### x ####)
-- x

Email Address

Briefly describe this manager's role with the proposed project

3. Budget/Funding Request

Amount Requested*
$

Total Revenues*
$

Total Expenses*
$

4. Size of Potential Audience

How many children (ages birth to 8) will be affected by the project?
 Less than 50 51-250 251-1000 1001-5000 More than 5000

5. Geographic Impact

List the communities in which project activities will take place.
 All of the city of Pittsburgh All of Allegheny County Other region(s) in Southwestern PA (list below) Specific neighborhoods (list below)

6. Timeframe

Project planning begins/began on*

Project activities begin on*

Project activities conclude on*

7. Project Statement

In 250 words or less, please provide a statement that summarizes the project for which you are requesting support.*

8. How did you hear about Spark?

 Spark Project Friend Radio, TV, or Newspaper Staff or Advisory Board Website Brochure Poster, Flyer, Handbill Public Art Murals & Activities Presentation at an Event

2009 Micro Spark Application Attachments

This form accepts files of the following types:
.DOC, .DOCX, .PDF, .ODF, .XLS, .XLSX, .JPG, .JPEG, .TIF, and .TIFF

Response to Application Questions *required*

Budget Attachment *required*

Timeline Attachment *required*

Supporting Materials 1 (optional; please describe)

Supporting Materials 2 (optional; please describe)

Supporting Materials 3 (optional; please describe)

Submit Application

Once you have completed all the required fields and selected the proper attachments for your application , click the Submit Application button below.

Your cover sheet information and application attachments will be emailed to The Sprout Fund. A copy of the submission will also be sent to the lead project manager's email address.

When submission is successful, all form fields above will be cleared and a message in a green box will appear below.