FALL APPLICATION REQUEST FORM

We appreciate your interest in signing your school up to receive the Philly Service Award grant application. Please note: this form is not the application, and schools completing this form will not receive funding until the short formal application is completed and approved.

After you sign up here, you will receive an acknowledgment of your pre-registration.
The application information will be sent at the beginning of the academic year.
Upon approval, eligible Philadelphia schools who apply will receive community service grants to complete their chosen projects.
All schools that receive grants and complete service projects will also have the opportunity to compete for additional funding for their schools.

School Name:

Zip Code Your School is Located In:

Must be a Philadelphia Zip Code

Primary Contact Name:

First Name

Last Name

Position at School:

Email:

Phone Number:

(###)

###

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Preferred Contact Method:

Email

Phone

Secondary Contact Name:

First Name

Last Name

Email

Position at School:

Phone

(###)

###

####

Preferred Contact Method

Email

Phone

Is there anything else you'd like to share with us at this time?