PennEast Powering STEM Grant Program Application (All fields required unless specified) Organization Info Organization Name (required) Organization Address City* Date of Request* Contact Name Contact Title Phone Number Email Address Website Social Media Pages (Optional): Are you a non-profit (501(c)(3)) organization? YesNo Have you applied for other PennEast Pipeline grant funds over the last 12 months? YesNo Project Info Please identify all communities your organization serves within the proposed path of the PennEast Pipeline. If you are a regional or statewide organization in Pennsylvania or New Jersey, please identify your organization’s footprint (or those you serve and where they’re from): Project Name Please identify the category or categories within STEM represented in your project: ScienceTechnologyEngineeringMathematics In two pages or less, provide a description of your project. Please provide a project overview; how your project relates to STEM; estimated number of individuals to partake; how the execution of your project will benefit your organization and community as a whole; a well-defined plan for review; project implementation timeline and why you feel your organization should receive a PennEast Powering STEM Grant: Please identify the amount of funding up to $10,000 you would like to apply for. $ Please identify all communities the organization serves within the pipeline path. Identify how the grant will be used including but not limited to the following: materials, equipment and supplies, transportation costs, teaching staff specifically related to the project and other budgetary items: Note: If selected for a PennEast Powering STEM grant, recipient agrees to allow PennEast to promote recipient in its communications. PennEast may also ask recipient to formally present grant at a ceremony, and/or ask if additional volunteer or support opportunities exist where PennEast personnel can buttress the grant’s financial support. If applicants are aware of such opportunities, they are encouraged to highlight these in their project description.