DPSEF Grant Form

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$51500

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Updated:
8/12/10

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Grant Form

Dearborn Education Foundation

18700 Audette, Dearborn, MI 48124 | T: 313.827.8790 F: 313.827.8791
Grant Request Form

Date *

Name of project *

School(s) & Department(s) *

Individual(s) requesting *

Primary contact email & school phone # *

Primary contact home or cell phone

Propsed beginning date *

Expected completion date *

Total anticipated cost *

Amount being requested *

Principal who approved *

Date principal approved *

Has this grant been presented to any other forum? *

Number of students to benefit from this project *

This grant will serve grade(s) *

Please note subject(s) this grant will serve *

Project description (provide all details to support your financial request) *

Objective & Expected Outcome(s) *

THE REMAINING IS TO BE FILLED OUT BY DPSEF ONLY

Reviewed by

Date

Decision Approved Partially approved Tabled Denied

DPS Check # and Amount

Date

Was a confirmation letter sent? Yes No N/A

Were invoices & other supporting documents supplied with this grant? Yes No

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