HSA Funds Request Form (Responses)
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1
Timestamp
Requester's name (your name, please)
What are you requesting?
Is this a budgeted request?
If budgeted, please add your budget line item (for instance, Foodprints Program)
Payment type needed?
And finally, when do you need these funds? (Ideally, this will be at least 10 days for budgeted items)
Request amount in dollars (just the value please)
Requester's contact email
Email Address
Requester's phone number
PresidentPrincipalTreasurerApprovedPaidPaid DateCheck # / Paid Method
2
6/19/2019 8:23:21Shannon Robichaud
ShowKit Purchase for the Drama Club
YesTheater Productions
Someone from HSA can pay MTI directly. See contract for details. If it's easier, a check can be made out to me and I can take care of it.
7/9/2019685yesyes
3
7/26/2019 8:46:23Shaquana BanksDeposit for DJ servicesYes
General School Picnic/Fair
Paid to Roger Hernandez, Jr- DJ Services
8/1/2019225yesyes
4
7/29/2019 10:22:59Philip TavaresAthletic Spirit ShirtsYesAthletics ProgramCredit Card8/2/20191798yesyes
5
7/29/2019 10:36:10Philip Tavares
Athletics Teamsnap Communication Platform
YesAthletics ProgramCredit Card8/20/2019964.32yesyes
6
7/29/2019 11:16:19Philip Tavares
Reimbursement for Athletic Storage Components
YesAthletics ProgramCheck8/12/2019453.29yesyes
7
7/31/2019 11:27:26Philip Tavares
Positive Coaching Alliance Workshop and Partnership
YesAthletics ProgramCredit Card8/2/20191150yesyes
8
8/7/2019 17:39:10Nicole Sparkman
Deposit for DJ per Shaquana Banks
Yes
General School Picnic/Fair
Check8/17/2019225nononononoSee line item #3
9
8/9/2019 0:23:18Brighton Payne
Temporary tattoos for membership campaign
Yes
School Merchandise Inventory Purchases (includes staff shirts)
Credit Card8/10/2019130.6yesyes
10
8/16/2019 13:00:31Tavares, Philip
Reimbursement for DPR Field permit of Francis field for Fall 2019
YesAthletics ProgramCheck9/6/201987.5yesyes
11
8/23/2019 15:31:51Erick Washington
2 bagless vacuum cleaners, drill bits, screwdrivers, pliers sey
No
Figure out the right payment
8/26/2019300nononononoNO
12
8/24/2019 8:44:01
Ibti Vincent (on behalf of Jenn Mampara)
Reimbursement for SWWFS garden tool shed
NoCheck9/6/2019666.74yesyes
13
8/27/2019 17:31:54shanna young
reimbursement for SWWFS pre-service week
Yes
School / Office Supplies (metro cards, photography backdrop, etc)
Check8/28/2019354.81yesyes
14
8/27/2019 17:33:01susan tso
reimbursement for ECE playdate
YesECE PlaydateCheck8/28/201963.93yesyes
15
8/27/2019 17:34:16shanna young
reimbursement for ECE palydate
YesECE PlaydateCheck8/28/201938yesyes
16
8/28/2019 14:58:11Sanda Blank
Reimbursement for t-shirts
Yes
School Merchandise Inventory Purchases (includes staff shirts)
Check9/16/20192630yesyes
17
9/3/2019 12:01:00Micah Siegel
Money for Field Trip to Common Good City Farm
YesField Trip SupportCheck9/9/2019125yesyes
18
9/3/2019 12:03:56Micah SiegelMoney for Field TripYesField Trip Support
Make credit card payment at point of sale, then reimburse with parental donation of $10
9/9/2019432.5yesyes
19
9/4/2019 11:42:04shanna young
Principal allocated funds
Yes
Staff Hospitality Events (includes staff breakfast)
Check9/6/2019400yesyes
20
9/5/2019 10:59:09Shaquana Wiley BanksReimbursementYesBoo-Hoo Breakfast
PayPal- Shaquana Banks or Cash App- $ShaquanaWileyBanks
9/15/2019107.83yesyesyes
21
9/8/2019 8:17:14Zachary Carroll
Reimbursement for purchased school supplies
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check9/19/2019330.48yesReimburse $325
22
9/8/2019 12:28:47Naelis Ervin
Spelling Bee Registration Funds
YesSpelling BeeCheck9/11/2019165yesyes
23
9/9/2019 8:34:47CeCe OgunshakinMUN FundsYes
Model United Nations Fees
Credit Card9/9/2019520yesyesReimburse $490
24
9/11/2019 15:53:40Shaquana Wiley BanksReimbursementYes
Staff Hospitality Events (includes staff breakfast)
Check9/21/201960yesyes
25
9/12/2019 11:12:46
Stephanie Beer and Anna Ramsey
money for breakfast food/drinks for ESL family breakfast
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/2/2019100yesyes
26
9/16/2019 19:18:06Test SparkmanTestYes
8th Grade Field Trip Assistance (Student/Faculty chaperons)
Test10/1/20191NICSPARX@gmail.com2024871879yesyes
27
9/17/2019 21:55:38Young Yi
computer parts to fix damaged laptops
YesTechnologyCheck9/20/2019944young.yi@dc.gov2027244841yesyes
28
9/18/2019 9:35:10Simone AndersonBus Service Yes
Transportation for Swim Program
Check9/18/2019452.62
simone.anderson2@k12.dc.gov
202.274.4841yesyes
29
9/18/2019 11:51:11Silean Eaves
Funds from Theater Line (NYC student trip)
YesTheater ProductionsCheck9/20/2019200
silean.eaves@k12.dc.gov
2027244841yesyes
30
9/19/2019 14:53:06Monica StephensonHSA FundsNo
Amazon Gift card for higher level reading books for kids
10/4/2019350
monica.stephenson@k12.dc.gov
2023228671nonoRequest unclear
31
9/23/2019 16:09:01Shannon RobichaudReimbursementYes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/11/201946.04
shannon.robichaud@k12.dc.gov
8605594589yesyes
32
9/24/2019 17:36:58Jennifer Myers
Subscription to Quizlet Teacher (allows for premium features on Quizlet vocabulary platform)
NoCheck10/1/201922
greyskymornings@gmail.com
2023417689nonoRequest unclear
33
9/26/2019 21:57:41Latasha Boone
Classroom pets and supplies
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/14/2019164.02
latasha.boone@k12.dc.gov
404-247-7104yesyes
34
9/27/2019 14:56:23Young Yi
Technology Supplies/Upgrades
YesTechnologyCheck10/1/2019500
shanna.young@k12.dc.gov
2027244841yesyes
35
10/3/2019 14:20:31Simone AndersonTransportation Yes
Transportation for Swim Program
Check10/3/20193000
simone.anderson2@k12.dc.gov
2027244841yesyes
36
10/4/2019 10:36:47Hillary R Webster
Reimbursement for supplies for auction fundraising/volunteer activity to qualify for Disney tickets
YesFall Auction ExpensesCheck10/15/2019200hill@hillarywebster.com2023686941yesyes
37
10/5/2019 16:00:41Sunny Chang
Teacher Support Materials
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/17/2019248.25
sunny.chang@k12.dc.gov
202-670-8807yesyes
38
10/5/2019 20:27:47Sanda Blankpayment to a vendorYes
School Merchandise Inventory Purchases (includes staff shirts)
Check10/18/2019431.4
sandablank@yahoo.com
2029047113yesyes
39
10/6/2019 20:46:12Jennifer Myers
Reimbursement for class reward (ice cream party)
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/21/201913jennifer.myers@dc.gov2023417689yesyes
40
10/8/2019 8:28:49Jennifer Myers
Quizlet.com Premium Membership (Vocabulary Platform for 5th Grade)
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/22/201920jennifer.myers@dc.gov2023417689yesyes
41
10/9/2019 12:14:55Jennifer Mampara
HSA contribution towards FoodPrints programming
YesFoodprints ProgramCheck11/1/201910000jenn@freshfarm.org2024924335yesyes
42
10/11/2019 9:32:01Cece OgunshakinMUN funds Yes
Model United Nations Fees
Credit Card10/11/201930
cicely.ogunshakin@k12.dc.gov
4103403936yesyes
43
10/11/2019 9:43:45cece ogunshakinmun fundsYes
Model United Nations Fees
Check10/11/201975
cicely.ogunshakin@k12.dc.gov
410-340-3936yesyes
44
10/17/2019 13:36:04Simone Anderson
Transportation Funds for Swimming Program
Yes
Transportation for Swim Program
Check10/17/2019326.97
simone.anderson2@k12.dc.gov
2027244841yesyes
45
10/18/2019 8:34:58Glady Diaz
Materials to Paint the Pig: Exterior Paint, sand paper, drop cloths and paint brushes
No
Staff Grade Level Discretionary Fund ($325/teacher)
Credit Card10/28/2019150glady.diaz@k12.dc.gov2404234448yesyes
46
10/22/2019 9:36:53Simone Anderson
Swimming Program Transportation
Yes
Transportation for Swim Program
Check10/31/20192022.45
simone.anderson2@k12.dc.gov
2027244841noyes
47
10/22/2019 10:21:10Justin Prinzbach
Funds from Last year's Latin Field Day
YesLatin Field DayCheck10/29/2019426.54
justin.prinzbach@k12.dc.gov
716-553-9285yesyes
48
10/22/2019 10:29:31Justin Prinzbach
Funds from Last year's Latin Field Day
YesLatin Field DayCheck10/29/2019426.54
justin.prinzbach@k12.dc.gov
716-553-9285nonoduplicate request
49
10/22/2019 10:32:54Justin Prinzbach
Last Year's Latin Field Day funds
YesLatin Field DayCheck10/29/201972.82
justin.prinzbach@k12.dc.gov
716-553-9285yesyes
50
10/22/2019 10:34:24Justin PrinzbachClassroom SuppliesYes
Staff Grade Level Discretionary Fund ($325/teacher)
Check10/29/2019173.9
justin.prinzbach@k12.dc.gov
716-553-9285yesyes
51
10/23/2019 9:20:08Katie Egan
materials for specialized instruction, counter chips, chair pickets, reading curriculum book
YesFacility ExpensesCredit Card10/31/201955.03katie.egan@k12.dc.gov4077602255yesyes
52
10/24/2019 19:02:34Gleeson Young
Payment for LEXIA unlimited licenses which will serve the entire school-ECE, ES and MS. This computer program is tailored to meet students where they are in reading and move them to proficiency
NoCheck12/1/20199000
gleeson.young@k12.dc.gov
2022584921nononot approved
53
10/25/2019 21:11:09Alex Boozier
Auction Reimbursement
NoCheck11/1/201940
alex.boozier25@gmail.com
2023379190yesyesneed more information
54
10/26/2019 22:51:10Jennifer Myers
Reimbursement for books purchased from DC Public Library Used Book Sale
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check11/8/201910
jennifer.myers@k12.dc.gov
2023417689yesyes
55
10/30/2019 10:42:22Shaquana Wiley BanksReimbursementYes
Open Houses (combined with Principal's Coffee in 2019-2020)
Check11/13/201954.66
swileybanks@yahoo.com
301-502-6165yesyes
56
10/30/2019 11:10:05Matt Webster
reimbursement for PODS storage
YesFacility ExpensesCheck11/29/20191639.75vp@swwfs.org2028888836yesyes
57
10/30/2019 11:11:20Matt Webster
reimbursement for MailChimp
YesTechnologyCheck11/29/201984.76vp@swwfs.org2028888836yesyes
58
11/5/2019 10:13:56Tanisha ChangPurchasing a bookYes
Staff Grade Level Discretionary Fund ($325/teacher)
Check11/11/201935.33
tanisha.nugent-chang@k12.dc.gov
2024452724yesyes
59
11/5/2019 21:12:34Sanda Blank
Reimbursement for 2020 Staff Appreciation
Yes
Staff Appreciation Week
Check11/18/2019203.5
sandablank@yahoo.com
202-904-7113yesyes
60
11/5/2019 21:36:08Sanda Blank
Staff appreciation purchase
Yes
Staff Appreciation Week
Check11/18/201931.66
sandablank@yahoo.com
202-904-7113yesyes
61
11/7/2019 8:24:41Silean Eaves
Funds for HIgh School Fair (from
YesMiddle School ActivitiesCheck11/12/201960
silean.eaves@k12.dc.gov
4436213739yesyes
62
11/7/2019 10:53:53Teressa West
Funds for Parent Breakfast
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check11/22/201940
teressa.west@k12.dc.gov
2547177673yesyes
63
11/8/2019 8:24:59Micah Siegel
Field Trip Funding Support
YesField Trip SupportCredit Card11/15/2019825
micah.seigel@k12.dc.gov
2027244841yesyes
64
11/8/2019 16:52:06Jennifer Myers
Reimbursement for classroom incentive/prizes
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check11/22/201950
jennifer.myers@k12.dc.gov
2023417689yesyes
65
11/11/2019 13:52:45Hillary R Webster
Check for Tynisha Murphy (Auction Babysitter)
YesFall Auction ExpensesCheck11/15/2019120hill@hillarywebster.com2023686941yesyes
66
11/11/2019 13:54:39Hillary R Webster
Check for Tiara Purnell (Auction Babysitter)
YesFall Auction ExpensesCheck11/15/2019120hill@hillarywebster.com2023686941yesyes
67
11/13/2019 7:38:23Zach Carroll
I am requesting funds for an experiential education activity for the entire 6th grade and select 7th and 8th graders. The second unit of the 6th grade curriculum focuses on the Americas. The culminating project asks students to follow the journey of a Cacao bean to explore ideas like sustainability, globalization, and fair trade. I would like to bring this process to life with a meaningful and hands-on experience. I reached out to a locally owned and operated chocolate shop, Harper Macaw, that promotes Fair Trade practices and educates the community on sustainability issues in chocolate production. I would like them to come to school to make a Fair Trade presentation, provide Cacao samples, and make chocolate with students. The visit is well timed with international education week as students will learn about and taste products from all over the Americas. Matt Dixon, co-owner of Harper Macaw, and I have been emailing back and forth to arrange logistics. Matt shared that each session (including samples, educational resources, employee time, and chocolate tasting) will cost $250. I want to run three sessions to allow each student to fully participate in the experience. There are also ties to the science curriculum as students will soon study states of matter. Exploring the process from a scientific lens, students will see first-hand how solids are transformed into liquids. Please call with me any questions about the funding request. Thanks!
NoCheck11/21/2019750
zachary.carroll@k12.dc.gov
301-412-9700yesyes
68
11/14/2019 16:02:53Noretia Hardge
Reinburstment for Wine purchase, fo Auction
NoCheck11/25/201966.24
noretia.hardge@k12.dc.gov
4046212002yesyes
69
11/14/2019 22:12:06Cece ogunshakin Teacher funds yesCheck11/18/201973.25
cicely.ogunshakin@k12.dc.gov
4103403926yesyes
70
11/14/2019 22:15:56Cece ogunshakin MUN FundsYes
Model United Nations Fees
Can it be ordered and delivered to the school?
11/21/201950
cicely.ogunshakin@k12.dc.gov
4103403936yesyes
71
11/20/2019 16:51:14 Carrie Brownlie
Payment to Flik catering for auction.
YesFall Auction ExpensesCheck11/30/2019500
c.rieger.brownlie@gmail.com
2022572439yesyes
72
11/21/2019 11:00:42Stephanie Beer
Reimbursement for supplies purchased for Culture and Cuisine Night
YesInternational NightCheck12/3/2019103.31
stephanie.beer@k12.dc.gov
8142339269yesyes
73
11/22/2019 14:02:01Kellie Barber
A field trip to Fantom Comics
YesField Trip SupportCheck12/11/201955
kellie.barber@k12.dc.gov
262-853-5887yesNeed more information
74
11/22/2019 16:51:24Philip Tavares
Reimbursement for coaches' departure gift and catering toward coaches' workshop, preseason basketball meeting, end of season soccer celebration
YesAthletics ProgramCheck12/13/20191113.49
philip.tavares@k12.dc.gov
2027244841yesyes
75
11/25/2019 13:35:28Philip TavaresLexia Learning LicenseNoCredit Card12/2/20199900
philip.tavares@k12.dc.gov
2027244841needs board approval
76
11/26/2019 12:00:38Micah Siegel
Mason Jars for Making Student Tornados
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check12/1/201919.99
micah.siegel@k12.dc.gov
978-979-1586yesyes
77
11/26/2019 12:21:30Micah Siegel
White Board Table Spots
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check12/1/201912.71
micah.siegel@k12.dc.gov
978-979-1586yesyes
78
11/30/2019 18:51:40Jennifer Myers
Reimbursement funds for classroom color printer
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check12/13/201955
jennifer.myers@k12.dc.gov
2023417689yesyes
79
12/1/2019 7:53:16Silean Eaves
Reimbursement for MS Dance-DJ
YesMiddle School ActivitiesCheck12/3/2019100
silean.eaves@k12.dc.gov
4436213739yesyes
80
12/1/2019 8:21:19Silean eaves
Reimbursement for Funds for HS Fair
YesMiddle School Activities
I was already reimbursed 60.00 for part of this cost. The request is for balance.
12/4/201916.69silean.eaves@dc.gov4436213739nonoalready reimbursed
81
12/1/2019 8:35:28Silean eaves
Reimbursement for Middle School Hallowwen event
YesMiddle School ActivitiesCheck12/4/201965.8
silean.eaves@k12.dc.gov
4436213739yesyes
82
12/1/2019 16:14:10sanda blank
reimbursement for French embassy auction purchase
YesFall Auction ExpensesCheck12/14/2019536
sandablank@yahoo.com
2029047113yesyes
83
12/1/2019 16:32:10sanda blank
(auction) reimbursement: glue, ice, case of wine
YesFall Auction ExpensesCheck12/14/201940.48
sandablank@yahoo.com
2029047113yesyes
84
12/3/2019 12:42:11Young Yi
Technology equipment for repairs
YesTechnologyCheck12/5/20191000
shanna.young@k12.dc.gov
2027244841yesyes
85
12/3/2019 17:00:44Cece Ogunshakin Field trip funds YesField Trip SupportCredit Card12/6/2019713.9
cicely.ogunshakin@l12.dc.gov
4103403936yesyes
Need more information-How many students? Have parents contributed?
86
12/10/2019 14:34:07Jon KelleyTest RequestNoTest of notification12/10/20190tech@swwfs.org7035935292yes
87
12/11/2019 15:03:36Dionna Clemons
Reimbursement for CPR/AED/First-Aid Training
YesAthletics ProgramCheck12/20/2019123
philip.tavares@k12.dc.gov
2027244841yesyes
88
12/11/2019 15:11:05Richard TrogischnothingNo
acknowledgement of access
12/20/20190
Richard.Trogisch@k12.dc.gov
401-440-9214yes
89
12/15/2019 20:41:45karin harrisonreimbursement NoCheck1/3/201983.83
karin.harrison@k12.dc.gov
301-299-6757nononeed more information
90
12/15/2019 20:43:30karin harrisonreimbursementYes
Staff Grade Level Discretionary Fund ($325/teacher)
Check1/3/201950.75
karin.harrison@k12.dc.gov
301-299-6757yesyes
91
12/16/2019 22:23:10Cece Ogunshakin
8th grade end of year cruise - deposit
Yes
8th Grade Promotion Ceremony/Reception
Credit Card12/20/2019798
cicely.ogunshakin@k12.dc.gov
4103403936yesyes
92
12/17/2019 14:12:30Noretia HardgeEdFest reinburstment YesEdFestCheck12/20/201982
noretia.hardge@k12.dc.gov
2027244841yesyes
93
12/17/2019 14:31:27Shanna Young
Steamer for school logo table cloth for assemblies, EdFest and other events.
NoCheck1/2/2020150
shanna.young@k12.dc.gov
2027244841yesyes
94
12/20/2019 3:41:26Naelis Ervin
Reimbursement (International Exposure Week Committee)
YesInternational NightCheck12/20/2019107.81
naelis.ervin@k12.dc.gov
4434688212yesyes
95
12/25/2019 22:49:38Jennifer Myers
Reimbursement for classroom competition incentive (three donut reward days)
Yes
Staff Grade Level Discretionary Fund ($325/teacher)
Check1/10/202050
jennifer.myers@k12.dc.gov
2023417689yesyes
96
12/28/2019 12:57:07Yumiko Locussol
Reimbursement for International Night Expenses
YesInternational NightCheck1/31/202093.92
yumiko.locussol@k12.dc.gov
2028410404yesyes
97
12/29/2019 14:31:24Sanda BlankReimbursementYesFall Auction ExpensesCheck1/20/202047.17
sandablank@yahoo.com
202-904-7113yesyes
98
1/1/2020 16:37:55Hillary Webster
Auction Expense Reimbursement
YesFall Auction ExpensesCheck1/15/2020200hill@hillarywebster.com2023686941yesyes
99
1/3/2020 12:48:12Kellie Barber
Middle school dance decoration
YesMiddle School ActivitiesCheck1/14/202062
kellie.barber@k12.dc.gov
262-853-5887yesyes
100
1/6/2020 14:58:36Silean eavesField trip YesField Trip SupportCredit Card1/7/2020720
silean.eaves@k12.dc.gov
4436213739yesyes
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