Public Media Innovation Fund Round Four

Application Form

All fields are required unless otherwise noted.

Project Title

Contact Information

Primary Contact Job Title Station

E-mail

Phone

Fax

Address 1 Address 2 (optional)

City

State

Zip

Budget

Amount Requested from CPB Total Project Budget

Project Summary

Summary

In 100 words or less, describe the project's purpose, goals, and primary activities.

Please note: This description will be used in screening applications and should be written thoughtfully.

Assumptions

In 100 words or less, describe the audience benefit you are hoping to achieve, the educational strategies that you plan to use and the target audience for the project. Please include the specific learning outcomes you hope to achieve and the quantitative and qualitative metrics to judge project success.

Please note: This description will be used in screening applications and should be written thoughtfully.

Project Questions

Is your project administered by a public broadcasting station or a station-owned entity? Yes No Does your project have a broadcast component? Yes No Is your radio or television station a medium or small sized station? Yes No Is your radio station designated as a Rural or Minority grantee in the CPB CSG program? Yes No N/A

Attachments

Narrative

Provide a three-page narrative that outlines the goals, metrics and outcomes of the project you wish to pursue. Attach as a Word document.

When attaching the Word file, the file name must end in .doc. Your file's name cannot have spaces, dashes, or slashes.

Attach Word document:

Budget

In addition to providing a breakdown of project costs to be covered by this grant in your detailed budget, please include cash and in-kind funds for the project from other sources. Attach as an Excel document.

When attaching the Excel file, the file name must end in .xls. Your file's name cannot have spaces, dashes, or slashes.

Attach an Excel file:

Timeline

What is your timetable for the project? What activities do you plan to engage in on that schedule, what deliverables do you plan to offer during that time? Attach as an Excel document.

When attaching the Excel file, the file name must end in .xls. Your file's name cannot have spaces, dashes, or slashes.

Attach an Excel file:

Submit Application

Please click the Submit Application button only once. Do not close this page while the submission process is underway. You will be directed to a new page confirming the application process is complete and you will receive a confirmation at the e-mail address you have provided. Thank you.