13 CAR pt. 27, Appendix A
1. Applicant's name, address, email and telephone number. [Applicant should be an Arkansas public school, charter school or private school applying for the benefit of specified students invited to participate in the NHD National Contest representing Arkansas.]
2. Name and mailing address of traveling student(s) and school/organization attended by student(s) invited to participate in the NHD National Contest representing Arkansas.
3. Total Number of Traveling Students:
4. Estimated Travel Expenses Per Student: ---
5. Total Amount of Grant Request ($600 maximum per student subject to available funding):
6. Proposed Grant Period (The period during which grant funds will be spent.)
From. _ . Month Day Year
To _ Month Day Year
To Apply
Applications will be accepted either via the Department of Arkansas Heritage online grant portal or via a paper application. The Notice of Grant Opportunity will specify method for submitting application. All applicants will be asked to provide the following information for each student receiving travel grant funds:
1. Completed NHD Student Information Sheet as required by National History Day - to be prepared by student.
2. Evidence of selection to attend NHD National Contest
3. Final Travel Expenditures (to be submitted within 30 days after last day of NHD National Contest) - For each traveling student, provide actual transportation costs. Transportation should be stated in the form of roundtrip miles and not exceed the state government rate per round trip mile for travel by automobile. Airfare/bus fare can be demonstrated by cost to purchase tickets. Provide the "from and to" locations. - For each traveling student, provide and itemized list of lodging expenditures which include each item, a unit cost, quantity and a total amount.
4. Completed form W-9 demonstrating tax exempt status.
5. Signed Certification of Use of Funds form developed by the Department of Arkansas Heritage.
6. Signed Supplemental Grant Information developed by the Department of Arkansas Heritage.
Department of Arkansas Heritage - NHD Travel Grant Program
I certify, to the best of my knowledge and belief, that all criteria and pre-conditions established in the application requesting travel funds for the benefit of student(s) invited to participate in the NHD National Contest have been met. I further certify that any funds received in accordance with the National History Day Travel Grant Program will be used specifically for the purposes listed in the grant award.
[Name of Program Leader or designated school official] (Date)
(Signature) (Title) (Print Name)
You must provide the following information pertaining to the location (city; county, district) in which the student benefitting from the travel grant resides. Submit this form along with your grant application. Please contact your county clerk's office at your local county courthouse if you do not know who your local government officials are.
Applicant Organization Name: _ Applicant's Address: _ Applicant's City/County: _ Traveling Student Name: _ Traveling Student Address:
Traveling Student City/County: _
Governing Mayor: County Judge:
State Senator: State Representative:
*Please note that some cities have multiple districts; please list the one applicable official.
Attachments required: title page, process paper; bibliography
Name
Mailing Address Parent or Guardian
School District and School (include address) Teacher and Grade
National History Day Entry Title Division and Category
I request reimbursement for these travel expenses:
Airfare (anticipated cost)
Mileage by personal auto (anticipated cost)
Other expenses while at the contest: Please list and a cost estimate.
Write a SO-word description of your project
What archives, museums or libraries did you use for your research? (List them here.)
Did you visit any museums, state parks, or other historical locations to gain information about your topic?
Did you conduct an oral history interview or other interview for your research? Please explain with whom and how the interview benefitted your research.
list your two most useful primary sources and two of your most useful secondary sources.