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ASDEF Activity Funding Request 2017 - 2018
This form is used to describe an activity improvement or other benefit to ASD, and request funding for same from ASDEF. Please provide the information to the best of your ability, and indicate estimates in the notes. ASDEF may make these forms available to future organizers to assist them in planning. All activities/goals must directly benefit the ASD school to be eligible for funding by ASDEF.
Activity name
Short name (ie - Destination Imagination, instruments, etc.)
Your answer
Request Date
Date of form submission.
Your answer
Activity Description
Provide a brief description of the activity.
Your answer
Responsible Party
Who will be responsible for organizing the activity (may list multiple names) List primary contact first.
Your answer
Contact Details
Phone numbers and any alternate email (the form records your username) List primary first.
Your answer
Total cost for the activity or equipment, etc.
What is the estimated total cost (materials/ travel/ fees etc)
Your answer
Units for total cost
You may give a specific dollar amount, a percentage of total need, or amount/ student.
Clarify "Other" choice if selected in units for total cost
Your answer
How accurate is the total cost estimate Describe any factors that make you uncertain of the Total need. (IE using last year’s numbers, or depends on participation)
Your answer
How much would you like ASDEF to consider providing? you may give a specific dollar amount, a percentage of total need, or amount/ student.
Your answer
What Grade levels are eligible to participate in the activity
enter all if no restrictions.
Your answer
List any age restrictions for participants
enter none if no restrictions on age.
Your answer
Describe how the activity benefits particpants
Your answer
Describe how the activity benefits the ASD community other than participants
Your answer
Describe what other fund sources will be used.
Will participants have a fee? Will tickets be use for attendance? Will participants hold a fundraiser? Other funds/grants involved?
Your answer
Is there a particular schedule of funding?
Lisa any timing considerations, ie upfront payment, then funding on date of activity, single payment, etc. Include specific dates if possible.
Your answer
Other notes.
Assist ASDEF in evaluating the request for funding of the activity
Your answer
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