Community Sparkplugs - Application
The Rensselaerville Institute, through its Community Sparkplugs work, partners with local citizens to create lasting change in their local communities. We believe that Community Sparkplugs is not about us, but about the people in their communities who desire to make a difference. When asked about Community Sparkplugs, the one thing to remember is that it is not what we do, not who we are. It is the outcomes that Community Sparkplugs achieve that define us.
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I am:
Applicants /Nominated Name *
Address - Please include city, state, zip *
Email *
Phone number *
Name of the program *
Description of the Program
Results & Targets
Each project will have targets that define what you want to achieve. At the end of the six months you will need to be able to tell your results story.
Setting Your Targets
This is where you determine your degree of change. Who will you affect and what will be different when you are done. Lastly, how will you verify it.
Define at least 2 targets that you will hit in 6 months.
Identify how many people your program will serve and how this will happen.
Defining Milestones
A milestone helps you manage your project. Focus' on the response others have to your actions. If we do "x" then people will do "y". Defines how progress is made to hit your targets.
Define at least 2 milestones you will hit in order to be successful in 6 months.
Assumptions & Learning
Reflect on what you think will happen. What change will occur when you're successful.
Assumptions & Learning
Media Release
I hereby authorize and permit The Rensselaerville Institute, staff and representatives the permission to photograph, publish, reproduce, record and use with or without my name or the name of the person for whom I am the parent/guardian. This includes but not limited to photographs, quotes, videotapes and personal stories or audio of me or the person for whom I am the parent/guardian.

I agree that The Rensselaerville Institute may use such photographs of me for any lawful purpose, including for example such purposes as education, information, illustration, and web content.

I have read and understand the above.
Applicants Signature
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