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PTO Grant Request Form
Use this form to request PTO approval of an expenditure you plan to make. If this request is approved, the PTO agrees to reimburse you for the requested amount, or the amount of your purchase (within reason).
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* Indicates required question
Your Name (first and last)
*
Your answer
your email address
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Your answer
Your Role at D69
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Teacher/Support Staff
Administration
Parent Volunteer (PTO)
Other
Required
Location (which school will use this item?)
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D69 Pre K
Madison Elementary
Edison Elementary
Lincoln Jr. High
District 69 (District or Multiple buildings)
Required
Brief Title of your request
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Your answer
Describe your request--include how it will benefit students or staff, what kind of program it will enhance, and logistics of how it will be managed if possible.
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Your answer
Expected Cost
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Your answer
Date Needed
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MM
/
DD
/
YYYY
Is this something that cannot be provided by the District? Have you explored that option?
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Your answer
Is this a recurring request? Have you made a similar request in the past? If so, please provide details.
Your answer
How many students will take advantage of, or benefit from, this request? (examples: The whole student body / Just the kids in my class this year / My current class plus all my future classes)
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Your answer
Will other teachers have access to the materials or will this be specifically for your classroom?
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Your answer
Additional Information (if needed)
Your answer
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