Paly PTSA Viking Grant Application Form
Applications will be accepted through April 7, 2021 or until the funds are exhausted.  Submit to Husna Hashmi (husnah@gmail.com). Requests for payments (receipts or invoices) must be submitted to the PTSA by 5 pm, May 3, 2021. Reimbursement forms can be found online:  https://www.jotform.com/form/12385643405
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Email *
Project/Program Title *
Contact Person (Name)
email
Date of application
MM
/
DD
/
YYYY
Total Budget for Project ($)
Amount requested ($)
E-signature of applicant (please acknowledge submittal by typing name below)
Department Instructional Supervisor Name
Describe your proposal in one or two sentences:
How did you arrive at this idea?
Which specific plan, goals, site or department plan objectives does this proposal address and how?
Is this a new or ongoing program?
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What is the target population and how many students will be served by this project/program each semester?
PTSA grant funds are awarded for use in the current school year.  What is the timeline for spending these funds?
List detailed expenses for this proposal. If full funding is not available, indicate your high priority items.
Do you presently have other sources of funding?  If so, please list.  If you are seeking alternative sources of funding, please list.
What are your plans for future funding if the project/program is recurring?
A copy of your responses will be emailed to the address you provided.
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