SMS Educator "Start Up Grant" Form
DEADLINE: November 5, 2021

Please be sure to read this document before completing this form https://docs.google.com/document/d/1gUYlM7RJILxONtM2fuVWkKZkmJTUDjOek7ZICuMmGVE/edit?usp=sharing
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Your Name *
Your WCPSS email address *
Grade Level(s) *
Select as many as apply.
Required
What subject(s) do you teach? *
Are you a member of the Salem Middle PTA? *
You DO NOT have to be a member in order to be eligible for a start-up grant, but people who are members no later than Oct. 15, 2021 will be given priority consideration for their request. Membership for SMS educators and staff is $5.00 per year.
Amount Requested for the Start-up Grant *
The total amount cannot exceed $100
Please describe how you spent the funds that you're now requesting for reimbursement via the start-up grant. *
 You do not need to be overly specific, but you are required to provide detail beyond just "classroom supplies." Please be sure that all things listed are actually used for educational purposes with your own students or students with whom you work (even if it's in a club). Please do not list things for personal use or professional development activities.
Please indicate your agreement with the text below and submit your form. *
"By submitting this request for the SMS PTA Teacher Start-Up Grant, I understand that I may be reimbursed for some portion of the amount requested or possibly not at all (depending on budget constraints). I understand that my reimbursement is not automatic and is subject to review by the SMS PTA leadership team. I understand that they may have further questions. I agree to keep any receipts that I have related to the expenses claimed on this form in order to produce on state or federal tax documents if needed."
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