MRIP Mini-Grant Completion Form Spring 2018
Please use this form to report back on the use of your MRIP Mini-Grant Funds. This form will be used as documentation of completion and you will need to upload invoices and/or receipts to this form.

If you have any questions, you may contact Megan Gruis at 612-499- 2310 or pbis.megan@gmail.com. Funding for this initiative is partially funded with a grant from the Minnesota Department of Education using state funds.

School District Name & Number
School Name
School Contact Person Name/Position
School Contact Email
School Contact Phone
District Business/Financial Contact Name (Check will be addressed to this person)
District Business/Financial Contact Email
District Business/Financial Contact Phone
Address of District Business/Financial Contact (where reimbursement check will be mailed to after June 30th)
Mini-Grant Award Amount
Number of Staff directly or indirectly served
Number of Students directly or indirectly served
Current Action Plan Goals (attach documentation)
Please describe your actual work using the Award Funding.
Please evaluate the impact of the award on your PBIS implementation.
Provide a detailed breakdown of your actual budget.
Attach invoices and/or receipts from purchases aligned with your grant proposal.
Project Supports *
Required
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