The Synopsys Outreach Foundation Green + 1 Challenge

Application Form

* Required Fields.
NOTE: Incorrect or invalid Email or Street Addresses will result in automatic cancellation of the application.
Please use caps and lowercase as appropriate.

Teacher Name: *
Primary Email Address: *
Secondary Email Address:
Phone Number: *	() -
Cell Phone Number: *	() -
School Name: *
School Address: *
City: *
Zip Code: *
Grade(s) Taught: *
My school is: *	Public Charter 501(c)(3) Non-Profit

About the Teacher
1. *	How long have you been teaching in the classroom?
2. *	Please describe any environmentally-related teaching experience you've had:
3. *	Please give us an example of a piece of scientific equipment or a program outside of your normal curriculum that you've incorporated into your teaching:
4. *	Please list any professional development programs in which you've participated over the course of your teaching career:
5. *	Please tell us about any green activities, organizations, or clubs in which you participate or have participated (in or out of school):
6. *	Have you undertaken any projects similar to the Green + 1 in duration and scope, whether related to the environment or not? If yes, please describe. (List links to any videos or websites that illustrate related endeavors)
7.	Please tell us what makes you a good candidate to receive a Green + 1 grant from the Synopsys Outreach Foundation - including your personal commitment to the environment. (This is optional - answer only if you want to provide information not included in the answers to the questions above)
About the Project
8. *	What is the title of your proposed project?
9. *	Please provide a brief description of your project:
10. *	What are the goals of your project?
11. *	How will you measure the impact of your project on the environment?
12. *	In what ways will the grant funds be put to use?