Small Station Training Scholarships

Application Form

All fields are required unless otherwise noted.

Project Title

Contact Information

This section must be completed by the Station General Manager.

Primary Contact Title

Phone

Fax

E-mail

Organization

Licensee or Organization Organization Type Federal ID or Social Security Number

Phone

Fax

E-mail

Address 1 Address 2

City

State

Zip

Representative

Attorney or Contract Representative

Phone

Fax

E-mail

Participants

Key Project Participants

List the project's subcontractors, licensees, community organizations, etc.

Project Information

Project Description

Describe the project's purpose, goals, and objectives in 150 words or less.

Project Start Date Project End Date Amount Requested from CPB Total Project Cost

Proposal

PLEASE NOTE

When attaching a file, your file's name must have an extension. Word file names must end in .doc, PDF files must end in .pdf, and Excel files must end .xls. Your file's name cannot have spaces, dashes, or slashes.

Detailed Project Proposal

Attach a Word or PDF file:

Itemized Project Budget

Attach a Word, Excel, or PDF file:

Additional Materials, if necessary

Attach a Word, Excel, or PDF file: