Hermanowski Family Foundation Initial Request Form

---

Organization Name: Ledyard Charter School
Legal Name (if Different):
Also Known As:
Mailing Address: 39 Hanover Street
City: Lebanon
State: NH
Postal Code:
Main Phone: 603-727-4772
Main Fax:
Organization Website: WWW.LEDYARDCHARTERSCHOOL.COM
Employer ID Number: 26-0376015
Organization Tax Status: 501 c 3 Tax Exempt

Proposal Information

---

Today’s Date: 2/3/22
Requested Amount: 5,000

Project Title: Student Wellness Program
Project Description:

Ledyard Charter School is requesting a donation of $5,000 to help with our Student Wellness Program. This program includes food pantry services, after school tutoring, counseling services, and even project and study hall space. All of our students are at-risk and Ledyard Charter School has become a safe harbor for them. We want to make our school as helpful to each student as possible.

Total Project Budget: 50,000

Other Funding
Sources For The Project (Committed & Potential): Mascoma Bank (committed) Pennies for Change (Committed)

Project Duration: Funds will be spent during grant cycle but project is on-going
Geographical Area Served: New Hampshire/Vermont
Age Group To Be Served: 13-18

Contact Information

---

Contact Prefix (Mr,Mrs etc.): Mrs.
Contact First Name: Jalaine
Contact Last Name: Stanton
Contact Title: Grant Manager
Contact Phone: 775-762-8323
Contact Email: jstanton@ledyardcharterschool.org