If you have questions while completing the report, please contact Eric Lipinski (firstname.lastname@example.org).
Note: Please consider compiling all of your responses into a Word document, then pasting them into this Google form once you have everything gathered. There is no save feature on this page.
If you would like a copy of this completed form for your records, PLEASE PRINT BEFORE SUBMITTING. The MDE will not be able to provide you with a copy of your answers. Thank you!
Only enter numerical figures in the boxes below or N/A if the box is irrelevant to your program.
If you wish to provide any further explanation, please do so in the final item of this section - entitled "Further Explanation on Cost Reporting".