GENIUM GROUP, INC.
PO Box 46 • Amsterdam, NY 12010 • 518-842-4111 • Fax 518-842-1843 • e-mail: cinquantim@genium.com

Butzel Foundation eCommPublishing Kit Grant Application

Please provide the following information to apply for a Grant subsidizing the full cost for licensing the eCommPublishing Kit during the 2009-2010 school year.

Your Name: __________________________________________________________________

Your e-mail Address: ___________________________________________________________

Representing What School District: _______________________________________________

Your Position/Office in the District: ________________________________________________

Name of School Where eCommEd Will be Used: ______________________________________

Street Address of School: _______________________________________________________

City: ________________________________ State: _____________ Zip: __________________

Name of School’s Principal: ______________________________________________________

Course(s) in Which eCommPub Kit Will Be Used: _____________________________________

Name of Instructor Who Will Teach Course: _________________________________________

Phone Number for Instructor: ____________________________________________________

e-mail address of Instructor: _____________________________________________________

Date you’d like to begin use of eCommPublishing: _______________________

• There is a limit to the number of Grants available, each year. Applications will therefore be approved and scheduled on a first-come, first-serve basis. This is why you are encouraged to complete and return this application as early in the current school year as possible, even if your school does not intend to use the eCommEd resource, immediately.
• Districts receiving this Grant agree that if, after using the eCommPublishing Kit during the current school year, the Instructor and his/her building administrator recommend that the District license the Kit again for the following year, the District will include the cost for doing so in your District’s Tentative Budget for the 2010-2011 school year. The current fee (as of 9/01/09) for licensing the eCommPublishing Kit during each school year is $499 per year.
• If you have any questions regarding the eCommPublishing Kit or terms and conditions of the Butzel Foundation’s eCommPublishing Grant, please contact Michael Cinquanti at the number listed above.

You can either mail your completed copy of this Application to Genium Group, at the address shown above or fax it to: 518-842-1843. You will be notified of the Butzel Foundation’s decision with respect to your application no later than five business days after receipt of your completed application.