Completion of this form indicates that 100% of the HOI 19 Kids Count One Class at a Time Grant will be spent as indicated in your grant request. HOI 19 News must have full cooperation from administrators to award teachers with the $1,000 check, which will be made payable to the school. Funds awarded will be the property of the school/classroom and not of the teacher. Classrooms from preschool to high school are eligible, and must be located in one of the following counties: Peoria Tazewell Woodford McLean Fulton Mason Stark Marshall Putnam Livingston County Funds may be used for supplies, classroom tools, or other educational necessities. Schools are not limited to the number of nominations submitted, but individual teachers are only eligible to win one grant. Photocopied applications are acceptable. All grants will be evaluated and awarded by the Kids Count Advisory Board comprised of educators, community leaders, and CEFCU and WHOI staff members. Please fill out the form below to be considered for the One Class At A Time Grant.
1.Submitter's Information
First Name* M.I. Last Name*

Email Address* Daytime Phone Evening Phone
2.Teacher's Name
5.School Administrator
6.School Address
7.Explain in 250 words or less how a $1,000 HOI 19 Kids Count "One Class At a Time" grant would further students' educational advancements and what it would mean to the class if selected. Note: This form will not accept submissions of more than 250 words.