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1 AspireIT APPLICATION WORKBOOK The document below is a copy of the online application you will be asked to complete to request funds. Note that this workbook actually contains 2 applications one for a new program and one for a program expansion. All dates are the same for both, and you can find them in the AspireIT Toolkit, but the questions vary slightly. If you have questions, please first refer to the resources in the AspireIT Toolkit, and then feel free to email us at [email protected]. NOTE: A link to the online application will be sent to the AspireIT Leader once the Partner Organization has completed the Partner Verification step. AspireIT: New Program or Program Expansion Carefully read through each of the application sections and work with your Proposal Team (Leader and Partner Organization) to complete and submit your application by the current deadline stated in the AspireIT Toolkit. You may complete the application tasks in any order, and you can save and edit them as you go. You will not be able to make any changes once it is submitted. Important: Before your application is submitted, your Partner Organization must be added as a collaborator to the application, and review and complete the Partner Verification task. Once that task is completed, the application will be automatically submitted. Questions? Be sure to review links provided in many questions. Check the AspireIT Toolkit for resources to help you in planning and preparing your program. You can also reach the team at [email protected] Have you run (not co-lead) and AspireIT program before? Yes No Is your AspireIT Partner Organization the same? Yes No Is your curriculum the same? Yes No Are the age-levels you intend to serve the same? Yes No If you answered “No” to any of the questions above, proceed to the New Program Application. If you answered “Yes” to ALL of the questions above, proceed to the Program Expansion Application.

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Page 1: AspireIT APPLICATION WORKBOOK · 1 AspireIT APPLICATION WORKBOOK The document below is a copy of the online application you will be asked to complete to request funds. Note that this

1

AspireIT APPLICATION WORKBOOK

The document below is a copy of the online application you will be asked to complete to

request funds. Note that this workbook actually contains 2 applications – one for a new

program and one for a program expansion. All dates are the same for both, and you can

find them in the AspireIT Toolkit, but the questions vary slightly. If you have questions, please

first refer to the resources in the AspireIT Toolkit, and then feel free to email us at

[email protected].

NOTE: A link to the online application will be sent to the AspireIT Leader once the

Partner Organization has completed the Partner Verification step.

AspireIT: New Program or Program Expansion Carefully read through each of the application sections and work with your Proposal Team (Leader and Partner Organization)

to complete and submit your application by the current deadline stated in the AspireIT Toolkit. You may complete the

application tasks in any order, and you can save and edit them as you go. You will not be able to make any changes once

it is submitted. Important: Before your application is submitted, your Partner Organization must be added as a collaborator

to the application, and review and complete the Partner Verification task. Once that task is completed, the application will be

automatically submitted. Questions? Be sure to review links provided in many questions. Check the AspireIT Toolkit for

resources to help you in planning and preparing your program. You can also reach the team at [email protected]

Have you run (not co-lead) and AspireIT program before? ❑ Yes ❑ No

Is your AspireIT Partner Organization the same? ❑ Yes ❑ No

Is your curriculum the same? ❑ Yes ❑ No

Are the age-levels you intend to serve the same? ❑ Yes ❑ No

If you answered “No” to any of the questions above, proceed to the New Program

Application.

If you answered “Yes” to ALL of the questions above, proceed to the Program Expansion

Application.

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AspireIT: NEW PROGRAM APPLICATION AspireIT: Basic Program Info

Program Name: ________________________________________________ NOTE: We will ask you to identify a more specific name for your session later.

AspireIT Program ID: _____________

If this is a brand new program, enter 0000.

If you are seeking funds to expand a program you have previously run, log into the AspireIT Portal, go to "My

Programs", and find your Program ID listed under the program name. Enter that number here.

If you were not previously the leader on record with us for the program (i.e. it doesn’t appear on your dashboard when

you log into the AspireIT Portal), then this is a NEW program and enter 0000.

Program Location: City/Town ______________________

Program Location: State __________________________

Which grade(s) do you plan to serve? Check all that apply.

Think about developmental and learning abilities. Good groupings to consider are: K-2; 2-4; 5-8; 8-12. Review the

Developmental Stages and Strategies Handout from the Engaging Program section of the AspireIT Toolkit for

additional guidance.

❑ K ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6 ❑ 7 ❑ 8 ❑ 9 ❑ 10 ❑ 11 ❑ 12

Brief Program Description (Limit 50 words):

In 50 words or less, give a high-level overview of your program.

Are you a member of a FIRST Team?

❑ Yes ❑ No

If Yes: Will members of your team be helping to present your AspireIT Program?

❑ Yes ❑ No

If Yes: What level FIRST is your team?

❑ FLL ❑ FTC ❑ FRC

If Yes: What is your team number & name?

Do you plan to work with a local library to provide space for your program?

❑ Yes ❑ No ❑ Unsure

If Yes: What is the name of the library?

Are you a TECHNOLOchicas Ambassador?

❑ Yes ❑ No

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AspireIT: Leader & Partner Info AspireIT Leader Info:

Provide contact info for the person completing this application (the AspireIT Leader).

Leader: First Name ________________________________________

Leader: Last Name ________________________________________

Leader: Email ____________________________________________

Leader: Phone (xxx-xxx-xxxx) _______________________________

Leader: Street Address _____________________________________

Leader: City ______________________

Leader: State _________________

Leader: Zip Code ______________________

Can you receive packages from a carrier like FedEx at the address above? The above address cannot be a P.O. box.

❑ Yes ❑ No

If No:

Leader Shipping: Street Address _____________________________________

Leader Shipping: City ______________________

Leader Shipping: State _____________________

Leader Shipping: Zip Code __________________

Tell us where you are in your journey:

❑ High School Student

❑ Undergraduate Student

❑ Graduate Student

❑ Career

Leader Demographics (optional)

❑ American Indian / Alaska Native

❑ Asian

❑ Black / African American

❑ Hispanics of any race

❑ Native Hawaiian / Other Pacific Islanders

❑ White

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❑ Two or more races

❑ Race / Ethnicity Unkown

❑ Person with Disability

AspireIT Partner Organization Info Provide us with basic information about your Partner Organization - we will ask them to provide more specific info

during their verification step at the end of the application. Remember:

Contact must be able to speak for the organization. So, if your contact is a volunteer then you will need to

have someone from the organization’s staff. If they are a student, then you will need to find a faculty contact.

Must match the organization and contact you were matched with during the AspireIT process prior to getting

to the application phase.

Contact cannot be a relative of the AspireIT Leader.

If your AspireIT Partner Organization is a For-Profit Corporation/Organization, you may still apply for AspireIT,

but you will not be eligible to receive any funds from NCWIT.

Partner Organization _____________________________________

Partner: First Name _____________________________________

Partner: Last Name ______________________

Partner: Email ______________________

Partner: Phone (xxx-xxx-xxxx) ______________________

AspireIT: New Program Application

Team Info AspireIT Leader: Have you participated in an AspireIT program before?

❑ No

❑ Yes, as a Leader

❑ Yes, as a Co-Leader

❑ Yes, as a Volunteer

❑ Yes, as a Participant

If Yes: Based on your past experience(s), what worked well and what would you change to have an even better program this

time? (Limit 150 words)

What specific experience does your Partner Organization bring to this program? How will they support and mentor your

program? (Limit 150 words)

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List the key members of your team, and their roles. (Limit 100 words) A successful program includes a team of multiple members who all bring their strengths to the table. Who will the key

members of your team be, and how will they aid in your program's success? Check the AspireIT Toolkit “Plan and

Apply” section for assistance.

Describe the leadership experience of you and your team members, particularly related to planning and delivering computer

related programs. (Limit 150 words)

The NCWIT AspireIT program is a collaborative effort between you, your partner organization, and other team members.

Describe how you and your team members will work together to plan and deliver this program. (Limit 150 words)

Program Curriculum Which of the following curriculum(s) do you plan to use for your program?

Check the Curriculum & Platform Library in the AspireIT Toolkit for more info on the platforms listed.

❑ AgentCubes

❑ Alice

❑ App Inventor

❑ Applied Digital Skills (Google)

❑ Arduino

❑ CleverBots Wonder Workshop

❑ CS First (Google)

❑ CS Unplugged

❑ Everyone Can Code (Apple)

❑ Khan Academy

❑ LEGO Mindstorms EV3

❑ Raspberry Pi

❑ Scratch

❑ Sphero

❑ TC LiFT

❑ Tynker

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❑ Unity

❑ WeScheme (Using Bootstrap Curriculum)

❑ Other (Explain Below) Other: Please Explain (Limit 150 words)

Tell us about the curricula you will use (not listed above), and give us a brief overview that demonstrates how it

focuses on computer science, coding, and/or computational thinking.

What learning goals do you have for your participants? What will they learn through participation in this program? (Limit 200

words) Use the Program Planning Guide worksheet in the AspireIT Toolkit to help you formulate and complete this section.

Provide a detailed description of your program, how the curricula selected above will be utilized, and how your plan will have

participants achieve the program goals stated above. (Limit 400 words)

Social Issue How will the participants apply what they are learning in your program to a social issue in their community? Add details and

examples. (Limit 200 words) Remember, this isn't about why it is important to offer programs to girls - but WHAT the girls are going to do IN your

program to tie what they are learning to their everyday lives. Check out the Social Issue Guide for additional

guidance.

Career Exploration How will this program help participants connect what they are learning to college and career opportunities in the field? Include

details and examples. (Limit 200 words)

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AspireIT: New Program Session

Program Session: Details

A Program Session is any group of AspireIT participants (at least 10) who attend your program and receive at least

12 hours of instruction. A Program Session has the same curriculum, same partner, same leader, same age-levels,

and same general format - regardless of where it is being presented.

As a new program and/or leader, you are eligible to apply for 1 program session. If you choose to expand this offering

in the next funding round you will be eligible to ask for funding for up to 3 sessions.

Program Session Name: _______________________________________________________________

This should be more specific than your Program Name. Something like Coding - New Library, or Scratch - Austin.

Is your program open to the general public or only to students/members of a specific organization? If participants must be students at specific schools or members of an organization like Girl Scouts or Girls, Inc, then

choose "Members Only"

❑ Public

❑ Member's Only

If Members only: Give us some details on who is eligible for your program. (100 word limit) What schools must they attend, or what organizations must they be a member of?

Anticipated Start Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

Anticipated End Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

How many participants do you plan to reach in this session (minimum of 10 required)? ______________

How many participants will receive at least 12 hours of programming? This is the minimum we expect you to meet -

but also affects the level of funding you can apply for, so balance accordingly. Failure to meet your goal could affect

future funding.

How many times will the program meet? ______________________

How long will each meeting be? Express as 0.00 hours. ______________________

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Your Hours per Participant = __________________

Auto-calculated in application form. Value is equal to (number of meetings) X (hours per meeting).

Eligible Funding Request Amount This is calculated by multiplying the total number of program hours that participants will receive by the number of participants

that will be served. Use this number to determine the maximum level of funding you may apply for.

$1500 - if your proposed Program delivers 120 - 250 total program hours

$2000 - if your proposed Program delivers 251 - 400 total program hours

$3000 - if your proposed Program delivers 401+ total program hours

Your Total Program Hours = __________________

Auto-calculated in application form. Value is equal to (hours per participant) X (# of participants)

Will you be charging a program fee? NCWIT HIGHLY encourages charging a program fee - even a nominal fee of $5 - $10 dramatically increases

attendance. Making a choice to make an investment in a program increases engagement and participation.

❑ Yes ❑ No

If Yes:

How much will your program fee be? ______________________

Will you be offering scholarships for your program? ❑ Yes ❑ No

If Yes: Give us some details about the scholarships you will offer. (50 word limit) How many scholarships will you offer, will they be full or partial, how will you determine who gets them?

If NO:

Please provide an explanation for why you are opting to not charge participants a fee for participation. (Limit 50

words)

Program Session: Participant Info While NCWIT recognizes that ALL women are underrepresented in the field of computer science, the AspireIT program has a

specific interest in reaching out to those women from the following populations who are most underrepresented in both

computer science education and industry: African American, American Indian, Alaska Native, Native Hawaiian, Pacific

Islander, Hispanic; persons with disabilities (defined as those with a physical or mental impairment that substantially limits one

or more major life activities); persons from remote, rural and/or high poverty areas.

Will your program specifically target participants from an underrepresented population? Specifically Target = 50%+ of your participants will come from the identified populations.

❑ Yes ❑ No

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If Yes:

Please select which underrepresented population(s) your program will serve. Check all that apply.

❑ African American ❑ American Indian ❑ Alaska Native

❑ Native Hawaiian ❑ Pacific Islander ❑ Hispanic

❑ Disabilities ❑ Rural ❑ High Poverty

Please provide details on the community you are planning to serve? (Limit 150 words)

What specific challenges will you need to overcome to recruit and engage your target population? How will you

overcome them? (Limit 150 words) Will you need to recruit in person, provide transportation, scholarships, bilingual instruction, adaptive

equipment?

Please describe your plan for recruiting participants - include both methods and timelines. (Limit 150 words) How will you reach out to the participants? Where will you advertise, what mediums will you use, etc.

AspireIT Budget: Program Session Are you requesting funding for your AspireIT program?

Remember, you may only request funds if you are partnered with a non-profit organization.

❑ Yes ❑ No

Will the AspireIT Leader (you) be compensated in some way? NCWIT HIGHLY recommends that the AspireIT Leader is compensated in some way. Examples include stipend,

hourly wage, school credits, scholarship, work-study funds, gift cards, community service hours. NCWIT does not

provide additional guidance.

❑ Yes ❑ No

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If Yes: Please explain how the AspireIT Leader will be compensated. Explain how this amount of compensation was arrived

at. (50 word limit)

If No: Please explain why you are opting to not include compensation for the AspireIT Leader. (50 word limit)

REMEMBER NCWIT AspireIT Program funds may be used for:

Implementation of new NCWIT AspireIT programs, or to continue, enhance or expand existing programs that already

meet specifications.

Stipends for Program Leader, Instructors, and Organizers.

Software or hardware used specifically to deliver the Program (robotics kits, circuit boards, etc.).

o Equipment may be retained for use in future AspireIT programs– it MAY NOT be kept or used for personal

purposes by AspireIT Leaders or Partner Organizations. If, however, the AspireIT program will not continue,

then the application must explain how any purchased technology equipment or software will be disbursed

upon completion of the Program. Food and materials for program delivery.

Transportation for program events such as field trips/tours.

Admission to program-related museums or events.

Recruitment activities for participants.

Stipends or Awards for participants.

A Recognition/Award Ceremony.

NCWIT AspireIT Program funds may NOT be used for:

Purchase of personal laptops or technology equipment for Program Leaders or sponsors to keep (any equipment

purchased must be fairly distributed to program participants at the end of the program).

Relieving debt of a club, organization, or Partner Organization.

Implementing pure research.

Lobbying.

Purchase of Alcoholic Beverages.

Tournament and/or entrance fees

Budget Details Use the form below to give us the details about your budget. Use "Other" fields to include categories that are not already

listed. Define what the category is in the "Explanation" field. For additional guidance and explanations of budget categories,

review the AspireIT Budget Workbook in the AspireIT Toolkit.

< form not included in this workbook – please use Budget workbook to draft your budget.>

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AspireIT: Timeline & Milestones

Timeline & Milestones Planning is key to success, and to stay on task it helps for you and your team to set up a timeline with deadlines for key tasks.

These might include the start of recruitment, registration open, program start/end, etc.

Use the form below to provide us with a timeline of your program's activities from award announcement through required post-

program activities. NOTE: The form requires that you enter at least 5 milestones.

Date (mm/dd/yyyy) Milestone

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Agreements & Certifications

Agreements and Certifications I certify that this program will be offered in an all-girl setting.

❑ I Agree

❑ I Disagree

I certify that I will be at least 14 years of age by the start of the program implementation window. (See timeline in AspireIT

Toolkit for current dates)

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❑ I Agree

❑ I Disagree

I certify that I have reviewed this application and budget with my AspireIT Partner Organization, and they agree with the

program and budget proposed.

❑ I Agree

❑ I Disagree

I understand and affirm that I am using funds properly and according to the guidelines outlined in this application.

❑ I Agree

❑ I Disagree

I, as the listed AspireIT Leader, agree to complete all required documents and reports related to this award. ❑ I Agree

❑ I Disagree

I authorize NCWIT representatives to text me with updates and information related to my AspireIT award. ❑ I Agree

❑ I Disagree

AspireIT: Partner Verification The following section must be completed by your Partner Organization Contact prior to the application deadline. Their

completion of this task and agreement will then automatically submit the application for NCWIT’s review. Your Partner will be

able to view your answers but not edit them. If they have changes that need to be made, they will need to work with you so

that you can make those edit.

AspireIT Partner Organization Partner Organization Name ____________________________________________

Organization Employer Identification Number (EIN) _________________________

Organization Type Please choose the one that best describes your organization.

❑ For-Profit Corporation/Organization

❑ K-12 School

❑ College/University

❑ Non-Profit: 4-H

❑ Non-Profit: Boys & Girls Club

❑ Non-Profit: Connect Home/Everyone On

❑ Non-Profit: FIRST Robotics

❑ Non-Profit: Future Farmers

❑ Non-Profit: Girls, Inc.

❑ Non-Profit: Girl Scouts

❑ Non-Profit: Girls Who Code

❑ Non-Profit: HUD/Public Housing Authority (PHA) • Non-Profit: Library (ALA)

❑ Non-Profit: MESA

❑ Non-Profit: Teach for America

❑ Non-Profit: YMCA

❑ Non-Profit: YWCA

❑ Non-Profit: Other

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Which NCWIT Alliance is your organization a member of? AspireIT Partner Organizations are required to be a member of one of the listed NCWIT Alliances. Learn more about

alliances and/or look up members on our website - wwww.ncwit.org/alliances

❑ K-12 Alliance

❑ K-12 Alliance (Associate Member)

❑ Academic Alliance (AA)

❑ Affinity Alliance

❑ Entrepreneurial Alliance (EA) • Workforce Alliance (WA)

Our NCWIT Alliance Membership is: ❑ Active

❑ Pending An application may still be submitted if membership is pending, but the membership must be approved before any award

can be made to the team.

Partner Contact Information Are you related to the AspireIT Leader? ❑ Yes ❑ No

Remember that the Partner Organization contact cannot be related to the Leader.

Partner Contact: First Name ______________________

Partner Contact: Last Name ______________________

Partner Contact: Email ______________________

Partner Contact Phone: Phone (xxx-xxx-xxxx) ______________________

Partner: Street Address __________________________________________________

Partner: City ______________________

Partner: State _____________

Partner: Zip Code ______________________

Can you receive packages from a carrier like FedEx at the address above? The above address cannot be a P.O. box.

❑ Yes ❑ No

If No:

Partner Shipping: Street Address _________________________________

Partner Shipping: City ______________________

Partner Shipping: State __________

Partner Shipping: Zip Code ______________________

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Partner Organization Approval As an AspireIT Partner Organization, if awarded, you will be the fiscal agent for this award. To that end, please review the

proposal that has been put together by the AspireIT Leader to ensure you are in agreement with the proposal and budget. If

you have any concerns, reach out to your leader to make adjustments. Completing this step will automatically submit the

application to NCWIT for funding consideration. Please be sure to complete this by the deadline indicated in the AspireIT

Timeline.

I have reviewed the attached proposal and confirm my organizations support for this project. ❑ I Agree

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AspireIT: PROGRAM EXPANSION

APPLICATION AspireIT: Basic Program Info

Program Name: ________________________________________________ NOTE: We will ask you to identify a more specific name for your session later.

AspireIT Program ID: _____________

If this is a brand new program, enter 0000.

If you are seeking funds to expand a program you have previously run, log into the AspireIT Portal, go to "My

Programs", and find your Program ID listed under the program name. Enter that number here.

Program Location: City/Town ______________________

Program Location: State __________________________

Which grade(s) do you plan to serve? Check all that apply.

Think about developmental and learning abilities. Good groupings to consider are: K-2; 2-4; 5-8; 8-12. Review the

Developmental Stages & Strategies Handout from the Engaging Program section of the AspireIT Toolkit for additional

guidance.

❑ K ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ 6 ❑ 7 ❑ 8 ❑ 9 ❑ 10 ❑ 11 ❑ 12

Brief Program Description (Limit 50 words):

In 50 words or less, give a high-level overview of your program.

AspireIT: Leader & Partner Info AspireIT Leader Info:

Provide contact info for the person completing this application (the AspireIT Leader).

Leader: First Name ________________________________________

Leader: Last Name ________________________________________

Leader: Email ____________________________________________

Leader: Phone (xxx-xxx-xxxx) _______________________________

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Leader: Street Address _____________________________________

Leader: City ______________________

Leader: State _________________

Leader: Zip Code ______________________

Can you receive packages from a carrier like FedEx at the address above? The above address cannot be a P.O. box.

❑ Yes ❑ No

Leader Shipping: Street Address _____________________________________

Leader Shipping: City ______________________

Leader Shipping: State _____________________

Leader Shipping: Zip Code __________________

Tell us where you are in your journey: ❑ High School Student

❑ Undergraduate Student

❑ Graduate Student

❑ Career

AspireIT Partner Organization Info Provide us with basic information about your Partner Organization - we will ask them to provide more specific info

during their verification step at the end of the application. Remember:

Contact must be able to speak for the organization. So, if your contact is a volunteer then you will need to

have someone from the organization’s staff. If they are a student, then you will need to find a faculty contact.

Must match the organization and contact you were matched with during the AspireIT process prior to getting

to the application phase.

Contact cannot be a relative of the AspireIT Leader.

If your AspireIT Partner Organization is a For-Profit Corporation/Organization, you may still apply for AspireIT,

but you will not be eligible to receive any funds from NCWIT.

Partner Organization _____________________________________

Partner: First Name _____________________________________

Partner: Last Name ______________________

Partner: Email ______________________

Partner: Phone (xxx-xxx-xxxx) ______________________

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AspireIT: Program Expansion Application

Remember: The reviewers assessing your answers do not have access to your previous application, so it is advised that you

share some details about each component to help them understand the successes and opportunities for improvement.

Program Curriculum Which of the following curriculum(s) do you plan to use for your program? This should be the same as your previous program,

and any explanation can be copied from your previous submission. ❑ AgentCubes

❑ Alice

❑ App Inventor

❑ Applied Digital Skills (Google)

❑ Arduino

❑ CleverBots Wonder Workshop

❑ CS First (Google)

❑ CS Unplugged

❑ Everyone Can Code (Apple)

❑ Khan Academy

❑ LEGO Mindstorms EV3

❑ Raspberry Pi

❑ Scratch

❑ Sphero

❑ Tynker

❑ Unity

❑ WeScheme (Using Bootstrap Curriculum)

❑ Other (Explain Below)

Other: Please Explain (Limit 150 words) Tell us about the curricula you will use (not listed above), and give us a brief overview that demonstrates how it focuses on

computer science, coding, and/or computational thinking.

Program Reflection Just as you and your participants grow, so should your program. Take a few moments to reflect on how your most recent

AspireIT program went and share your experience below.

Overall, what worked awesome in your last program? (300-word limit)

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Overall, what didn’t work as you expected? What changes will you make to address those challenges? (300-word limit)

Team Reflection

Think about your team - both your Proposal Team (you and your Partner Organization) and your Implementation Team (all of those who helped you put on your program.)

Overall, how did your team work well together? (300-word limit) Overall, what opportunities do you have to improve the way in which your team works together? (300-word limit) Team Members & Roles For this application, who will your team members be and what will their roles be?

Program Participants Briefly describe your target audience and recruitment strategies for your previous program. (200 word limit)

Did your previous program session reach your intended number of participants? ❑ Yes ❑ No

Did your previous program session reach your intended target audience? ❑ Yes ❑ No

If No: Please explain why you think you fell short and what changes you will make to address this. (300-word limit)

Participant Learning Goals Briefly describe the learning goals for your previous program (200-word limit)

Did your participants achieve the learning goals that you set? ❑ Yes ❑ No

If Yes: What evidence can you point to that shows your participants achieved these goals? (300-word limit)

If No: What changes will you make to ensure that your participants achieve your intended learning goals? (300-word limit)

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Do you wish to update your program's learning goals? ❑ Yes ❑ No

If Yes: What are your updated learning goals for participants? (300-word limit) Use the Program Planning Guide worksheet in the AspireIT Toolkit to help you formulate and complete this section.

Social Issue - Real World Connections Briefly describe the social issue component for your previous program. (200-word limit)

Did the social issue component of your last program achieve the outcomes you had hoped? Do you feel that your participants left your program with a good understanding of how what they learned can be

applied to their own lives and the issues that they care about?

❑ Yes ❑ No

If Yes: Share your evidence for why you feel that your participants achieved the goals you had.

If No: Tell us why you feel that the goals were not met. How do you plan to strengthen this component of your program in this

iteration?

Do you need to update the social issue component of your program from your previous application? You should provide an update if there are significant changes to how you will implement this component of your

program based on past lessons.

❑ Yes ❑ No

If Yes: What are your updated plans for implementing the program's social issue component? (300-word limit)

Career Exploration Briefly describe the career exploration component for your last program. (200-word limit)

Did the career exploration component of your last program achieve the outcomes you had hoped?

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Do you feel that your participants left your program with a good understanding of the types of jobs available in the

computer science/technology fields? Did they leave with an understanding of what those jobs do and look like?

❑ Yes ❑ No

If Yes: Share your evidence for why you feel that your participants achieved the goals you had. (300-word limit)

If No: Tell us why you feel that the goals were not met. How do you plan to strengthen this component of your program in this

iteration? (300-word limit)

Do you need to update the career exploration component of your program from your previous application? You should provide an update if there are significant changes to how you will implement this component of your

program based on past lessons.

❑ Yes ❑ No

If Yes: What are your updated plans for implementing the program's career exploration component? (300-word limit)

AspireIT: Program Expansion Sessions (1-3)

Program Session: Details A Program Session is any group of AspireIT participants (at least 10) who attend your program and receive at least 12 hours

of instruction. A Program Session has the same curriculum, same partner, same leader, same age-levels, and same general

format - regardless of where it is being presented.

As a returning Leader running the same program as before, you are eligible to apply for request funding for up to 3 new

sessions.

NOTE: Request for funding for multiple sessions is not a guarantee of funding. NCWIT may decide to fund none, one,

or multiple sessions depending on the proposal and the funds we have available to award.

How many Program Sessions would you like to apply for? ❑ 1 ❑ 2 ❑ 3

Program Session #1: Details Program Session #1 Name: _______________________________________________________________

This should be more specific than your Program Name, and each program session name should also be unique.

Something like Coding - New Library, or Scratch - Austin.

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Is your program open to the general public or only to students/members of a specific organization? If participants must be students at specific schools or members of an organization like Girl Scouts or Girls, Inc, then

choose "Members Only"

❑ Public

❑ Member's Only

If Members only: Give us some details on who is eligible for your program. (100-word limit)

What schools must they attend, or what organizations must they be a member of?

Anticipated Start Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

Anticipated End Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

How many participants do you plan to reach in this session (minimum of 10 required)? ______________

How many participants will receive at least 12 hours of programming? This is the minimum we expect you to meet -

but also affects the level of funding you can apply for, so balance accordingly. Failure to meet your goal could affect

future funding.

How many times will the program meet? ______________________

How long will each meeting be? Express as 0.00 hours. ______________________

Your Hours per Participant = __________________

Auto-calculated in application form. Value is equal to (number of meetings) X (hours per meeting).

Eligible Funding Request Amount This is calculated by multiplying the total number of program hours that participants will receive by the number of participants

that will be served. Use this number to determine the maximum level of funding you may apply for.

$1500 - if your proposed Program delivers 120 - 250 total program hours

$2000 - if your proposed Program delivers 251 - 400 total program hours

$3000 - if your proposed Program delivers 401+ total program hours

Your Total Program Hours = __________________

Auto-calculated in application form. Value is equal to (hours per participant) X (# of participants)

Will you be charging a program fee? NCWIT HIGHLY encourages charging a program fee - even a nominal fee of $5 - $10 dramatically increases

attendance. Making a choice to make an investment in a program increases engagement and participation.

❑ Yes ❑ No

If Yes:

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How much will your program fee be? ______________________

Will you be offering scholarships for your program? ❑ Yes ❑ No

If Yes: Give us some details about the scholarships you will offer. (50 word limit) How many scholarships will you offer, will they be full or partial, how will you determine who gets them?

If NO: Please provide an explanation for why you are opting to not charge participants a fee for participation. (Limit 50

words)

Program Session: Participant Info While NCWIT recognizes that ALL women are underrepresented in the field of computer science, the AspireIT program has a

specific interest in reaching out to those women from the following populations who are most underrepresented in both

computer science education and industry: African American, American Indian, Alaska Native, Native Hawaiian, Pacific

Islander, Hispanic; persons with disabilities (defined as those with a physical or mental impairment that substantially limits one

or more major life activities); persons from remote, rural and/or high poverty areas.

Will your program specifically target participants from an underrepresented population? Specifically Target = 50%+ of your participants will come from the identified populations.

❑ Yes ❑ No

If Yes:

Please select which underrepresented population(s) your program will serve. Check all that apply. ❑ African American ❑ American Indian ❑ Alaska Native

❑ Native Hawaiian ❑ Pacific Islander ❑ Hispanic ❑ Disabilities ❑ Rural ❑ High Poverty

Please provide details on the community you are planning to serve? (Limit 150 words)

What specific challenges will you need to overcome to recruit and engage your target population? How will you

overcome them? (Limit 150 words) Will you need to recruit in person, provide transportation, scholarships, bilingual instruction, adaptive

equipment?

Please describe your plan for recruiting participants - include both methods and timelines. (Limit 150 words) How will you reach out to the participants? Where will you advertise, what mediums will you use, etc.

Program Session #2: Details

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Program Session #2 Name: _______________________________________________________________ This should be more specific than your Program Name, and each program session name should also be unique.

Something like Coding - New Library, or Scratch - Austin.

Is your program open to the general public or only to students/members of a specific organization? If participants must be students at specific schools or members of an organization like Girl Scouts or Girls, Inc, then

choose "Members Only"

❑ Public

❑ Member's Only

If Members only: Give us some details on who is eligible for your program. (100 word limit) What schools must they attend, or what organizations must they be a member of?

Anticipated Start Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

Anticipated End Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

How many participants do you plan to reach in this session (minimum of 10 required)? ______________

How many participants will receive at least 12 hours of programming? This is the minimum we expect you to meet -

but also affects the level of funding you can apply for, so balance accordingly. Failure to meet your goal could affect

future funding.

How many times will the program meet? ______________________

How long will each meeting be? Express as 0.00 hours. ______________________

Your Hours per Participant = __________________

Auto-calculated in application form. Value is equal to (number of meetings) X (hours per meeting).

Eligible Funding Request Amount This is calculated by multiplying the total number of program hours that participants will receive by the number of participants

that will be served. Use this number to determine the maximum level of funding you may apply for.

$1500 - if your proposed Program delivers 120 - 250 total program hours

$2000 - if your proposed Program delivers 251 - 400 total program hours

$3000 - if your proposed Program delivers 401+ total program hours

Your Total Program Hours = __________________

Auto-calculated in application form. Value is equal to (hours per participant) X (# of participants)

Will you be charging a program fee?

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NCWIT HIGHLY encourages charging a program fee - even a nominal fee of $5 - $10 dramatically increases

attendance. Making a choice to make an investment in a program increases engagement and participation.

❑ Yes ❑ No

If Yes:

How much will your program fee be? ______________________

Will you be offering scholarships for your program? ❑ Yes ❑ No

If Yes: Give us some details about the scholarships you will offer. (50 word limit) How many scholarships will you offer, will they be full or partial, how will you determine who gets them?

If NO: Please provide an explanation for why you are opting to not charge participants a fee for participation. (Limit 50

words)

Program Session: Participant Info While NCWIT recognizes that ALL women are underrepresented in the field of computer science, the AspireIT program has a

specific interest in reaching out to those women from the following populations who are most underrepresented in both

computer science education and industry: African American, American Indian, Alaska Native, Native Hawaiian, Pacific

Islander, Hispanic; persons with disabilities (defined as those with a physical or mental impairment that substantially limits one

or more major life activities); persons from remote, rural and/or high poverty areas.

Will you be serving the same population that you described in the previous Program Session?

❑ Yes ❑ No

If Yes: You do not need to fill out the remaining part of this program session information.

Will your program specifically target participants from an underrepresented population? Specifically Target = 50%+ of your participants will come from the identified populations.

❑ Yes ❑ No

If Yes:

Please select which underrepresented population(s) your program will serve. Check all that apply. ❑ African American ❑ American Indian ❑ Alaska Native

❑ Native Hawaiian ❑ Pacific Islander ❑ Hispanic ❑ Disabilities ❑ Rural ❑ High Poverty

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Please provide details on the community you are planning to serve? (Limit 150 words)

What specific challenges will you need to overcome to recruit and engage your target population? How will you

overcome them? (Limit 150 words) Will you need to recruit in person, provide transportation, scholarships, bilingual instruction, adaptive

equipment?

Please describe your plan for recruiting participants - include both methods and timelines. (Limit 150 words) How will you reach out to the participants? Where will you advertise, what mediums will you use, etc.

Program Session #3: Details Program Session #3 Name: _______________________________________________________________

This should be more specific than your Program Name, and each program session name should also be unique.

Something like Coding - New Library, or Scratch - Austin.

Is your program open to the general public or only to students/members of a specific organization? If participants must be students at specific schools or members of an organization like Girl Scouts or Girls, Inc, then

choose "Members Only"

❑ Public

❑ Member's Only

If Members only: Give us some details on who is eligible for your program. (100 word limit) What schools must they attend, or what organizations must they be a member of?

Anticipated Start Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

Anticipated End Date: (MM/DD/YYYY) ___________________________ You can change this date later, if needed, but give us a sense of when you are thinking your program will start.

Review the timeline in the AspireIT Toolkit to acceptable implementation dates.

How many participants do you plan to reach in this session (minimum of 10 required)? ______________

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How many participants will receive at least 12 hours of programming? This is the minimum we expect you to meet -

but also affects the level of funding you can apply for, so balance accordingly. Failure to meet your goal could affect

future funding.

How many times will the program meet? ______________________

How long will each meeting be? Express as 0.00 hours. ______________________

Your Hours per Participant = __________________

Auto-calculated in application form. Value is equal to (number of meetings) X (hours per meeting).

Eligible Funding Request Amount This is calculated by multiplying the total number of program hours that participants will receive by the number of participants

that will be served. Use this number to determine the maximum level of funding you may apply for.

$1500 - if your proposed Program delivers 120 - 250 total program hours

$2000 - if your proposed Program delivers 251 - 400 total program hours

$3000 - if your proposed Program delivers 401+ total program hours

Your Total Program Hours = __________________

Auto-calculated in application form. Value is equal to (hours per participant) X (# of participants)

Will you be charging a program fee? NCWIT HIGHLY encourages charging a program fee - even a nominal fee of $5 - $10 dramatically increases

attendance. Making a choice to make an investment in a program increases engagement and participation.

❑ Yes ❑ No

If Yes:

How much will your program fee be? ______________________

Will you be offering scholarships for your program? ❑ Yes ❑ No

If Yes: Give us some details about the scholarships you will offer. (50 word limit) How many scholarships will you offer, will they be full or partial, how will you determine who gets them?

If NO: Please provide an explanation for why you are opting to not charge participants a fee for participation.

(Limit 50 words)

Program Session: Participant Info While NCWIT recognizes that ALL women are underrepresented in the field of computer science, the AspireIT program has a

specific interest in reaching out to those women from the following populations who are most underrepresented in both

computer science education and industry: African American, American Indian, Alaska Native, Native Hawaiian, Pacific

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Islander, Hispanic; persons with disabilities (defined as those with a physical or mental impairment that substantially limits one

or more major life activities); persons from remote, rural and/or high poverty areas.

Will you be serving the same population that you described in the previous Program Session?

❑ Yes ❑ No

If Yes: You do not need to fill out the remaining part of this program session information.

Will your program specifically target participants from an underrepresented population? Specifically Target = 50%+ of your participants will come from the identified populations.

❑ Yes ❑ No

If Yes:

Please select which underrepresented population(s) your program will serve. Check all that apply. ❑ African American ❑ American Indian ❑ Alaska Native

❑ Native Hawaiian ❑ Pacific Islander ❑ Hispanic ❑ Disabilities ❑ Rural ❑ High Poverty

Please provide details on the community you are planning to serve? (Limit 150 words)

What specific challenges will you need to overcome to recruit and engage your target population? How will you

overcome them? (Limit 150 words) Will you need to recruit in person, provide transportation, scholarships, bilingual instruction, adaptive

equipment?

Please describe your plan for recruiting participants - include both methods and timelines. (Limit 150 words) How will you reach out to the participants? Where will you advertise, what mediums will you use, etc.

AspireIT Budget: Program Session Are you requesting funding for your AspireIT program?

Remember, you may only request funds if you are partnered with a non-profit organization.

❑ Yes ❑ No

Will the AspireIT Leader (you) be compensated in some way? NCWIT HIGHLY recommends that the AspireIT Leader is compensated in some way. Examples include stipend,

hourly wage, school credits, scholarship, work-study funds, gift cards, community service hours. NCWIT does not

provide additional guidance.

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❑ Yes ❑ No

If Yes: Please explain how the AspireIT Leader will be compensated. Explain how this amount of compensation was arrived

at. (50 word limit)

If No: Please explain why you are opting to not include compensation for the AspireIT Leader. (50 word limit)

REMEMBER NCWIT AspireIT Program funds may be used for:

Implementation of new NCWIT AspireIT programs, or to continue, enhance or expand existing programs that already

meet specifications.

Stipends for Program Leader, Instructors, and Organizers.

Software or hardware used specifically to deliver the Program (robotics kits, circuit boards, etc.).

o Equipment may be retained for use in future AspireIT programs– it MAY NOT be kept or used for personal

purposes by AspireIT Leaders or Partner Organizations. If, however, the AspireIT program will not continue,

then the application must explain how any purchased technology equipment or software will be disbursed

upon completion of the Program. Food and materials for program delivery.

Transportation for program events such as field trips/tours.

Admission to program-related museums or events.

Recruitment activities for participants.

Stipends or Awards for participants.

A Recognition/Award Ceremony.

NCWIT AspireIT Program funds may NOT be used for:

Purchase of personal laptops or technology equipment for Program Leaders or sponsors to keep (any equipment

purchased must be fairly distributed to program participants at the end of the program).

Relieving debt of a club, organization, or Partner Organization.

Implementing pure research.

Lobbying.

Purchase of Alcoholic Beverages.

Tournament and/or entrance fees

Budget Details Use the form below to give us the details about your budget. Use "Other" fields to include categories that are not already

listed. Define what the category is in the "Explanation" field. For additional guidance and explanations of budget categories,

review the AspireIT Budget Workbook in the AspireIT Toolkit.

< form not included in this workbook – please use Budget workbook to draft your budget.>

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AspireIT: Timeline & Milestones

Timeline & Milestones Planning is key to success, and to stay on task it helps for you and your team to set up a timeline with deadlines for key tasks.

These might include the start of recruitment, registration open, program start/end, etc.

Use the form below to provide us with a timeline of your program's activities from award announcement through required post-

program activities. NOTE: The form requires that you enter at least 5 milestones.

Date (mm/dd/yyyy) Milestone

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Agreements & Certifications

Agreements and Certifications I certify that this program will be offered in an all-girl setting.

❑ I Agree

❑ I Disagree

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I certify that I will be at least 14 years of age by the start of the program implementation window. (See timeline in AspireIT

Toolkit for current dates) ❑ I Agree

❑ I Disagree

I certify that I have reviewed this application and budget with my AspireIT Partner Organization, and they agree with the

program and budget proposed.

❑ I Agree

❑ I Disagree

I understand and affirm that I am using funds properly and according to the guidelines outlined in this application. ❑ I Agree

❑ I Disagree

I, as the listed AspireIT Leader, agree to complete all required documents and reports related to this award. ❑ I Agree

❑ I Disagree

I authorize NCWIT representatives to text me with updates and information related to my AspireIT award.

❑ I Agree

❑ I Disagree

AspireIT: Partner Verification The following section must be completed by your Partner Organization Contact prior to the application deadline. Their

completion of this task and agreement will then automatically submit the application for NCWIT’s review. Your Partner will be

able to view your answers but not edit them. If they have changes that need to be made, they will need to work with you so

that you can make those edit.

AspireIT Partner Organization Partner Organization Name ____________________________________________

Organization Employer Identification Number (EIN) _________________________

Organization Type Please choose the one that best describes your organization.

❑ For-Profit Corporation/Organization

❑ K-12 School

❑ College/University

❑ Non-Profit: 4-H

❑ Non-Profit: Boys & Girls Club

❑ Non-Profit: Connect Home/Everyone On

❑ Non-Profit: FIRST Robotics

❑ Non-Profit: Future Farmers

❑ Non-Profit: Girls, Inc.

❑ Non-Profit: Girl Scouts

❑ Non-Profit: Girls Who Code

❑ Non-Profit: HUD/Public Housing Authority (PHA) • Non-Profit: Library (ALA)

❑ Non-Profit: MESA

❑ Non-Profit: Teach for America

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❑ Non-Profit: YMCA

❑ Non-Profit: YWCA

❑ Non-Profit: Other

Which NCWIT Alliance is your organization a member of? AspireIT Partner Organizations are required to be a member of one of the listed NCWIT Alliances. Learn more about

alliances and/or look up members on our website - wwww.ncwit.org/alliances

❑ K-12 Alliance

❑ K-12 Alliance (Associate Member)

❑ Academic Alliance (AA)

❑ Affinity Alliance

❑ Entrepreneurial Alliance (EA) • Workforce Alliance (WA)

Our NCWIT Alliance Membership is: ❑ Active

❑ Pending An application may still be submitted if membership is pending, but the membership must be approved before any award

can be made to the team.

Partner Contact Information Are you related to the AspireIT Leader? ❑ Yes ❑ No

Remember that the Partner Organization contact cannot be related to the Leader.

Partner Contact: First Name ______________________

Partner Contact: Last Name ______________________

Partner Contact: Email ______________________

Partner Contact Phone: Phone (xxx-xxx-xxxx) ______________________

Partner: Street Address __________________________________________________

Partner: City ______________________

Partner: State _____________

Partner: Zip Code ______________________

Can you receive packages from a carrier like FedEx at the address above? The above address cannot be a P.O. box.

❑ Yes ❑ No

If No:

Partner Shipping: Street Address _________________________________

Partner Shipping: City ______________________

Partner Shipping: State __________

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Partner Shipping: Zip Code ______________________

Partner Organization Approval As an AspireIT Partner Organization, if awarded, you will be the fiscal agent for this award. To that end, please review the

proposal that has been put together by the AspireIT Leader to ensure you are in agreement with the proposal and budget. If

you have any concerns, reach out to your leader to make adjustments. Completing this step will automatically submit the

application to NCWIT for funding consideration. Please be sure to complete this by the deadline indicated in the AspireIT

Timeline.

I have reviewed the attached proposal and confirm my organizations support for this project. ❑ I Agree