SusannaDickinsonPTO
GrantRequestForm
Please contact [email protected] with any questions.
Proposals may be for projects, activities, books, equipment or anything that enhances the academic lives of
children at Dickinson Elementary School. While preference is given to proposals that offer school-wide access to
students, teachers, staff and/or parents are also encouraged to submit proposals that will benefit their individual
classrooms or grade level. 1) Complete the grant request portion of this form and attach all detailed information. Please complete one form for each vendor.
2) Place this form in Dr. Mumphord’s box for review.
Grant Request
Staff Name: _______________________________________ Email: ______________________________________ Date: _________________
Grade Level/Dept: ________________________________________________________Date Needed: __________________________________
Description of Item(s) Requesting:
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Item(s) to be used for: __________________________________________________________________________________________________
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Vendor: ______________________________________________________________________________________________________________
□ Classroom Funds □ Grade Level Funds □ Field Trip □ Specials
□ Department: ________________________________ □ Other: ____________________________________________
Please choose a category:
FOR PTO USE ONLY:
Principal Approval:_____________________________
Dickinson Elementary PTO Grant Request Form
PTO Approval:____________________________________
Date Updated 08/16