6010 - Finanical Request Form

REQUEST TO THE BOARD FOR FINANCIAL CONTRIBUTION IN SUPPORT OF AN EMPLOYEE OF THE BOARD, A STUDENT OR STUDENTS ATTENDING SCHOOL WITHIN THE DISTRICT, OR AN ACTIVITY WHICH IS SPONSORED BY OR APPROVED BY THE BOARD OF EDUCATION OR THE DISTRICT SUPERINTENDENT.

Date request is submitted ____________________________________________________________

Name of person submitting the request. ________________________________________________

Name or names of the person or persons for whom the request is submitted. 


Specific current assignment of those for whom the request is submitted.

___________________________________________________________________________________

Detailed description of the use which is to be made of the funds which are requested


If the funds requested are in support of an activity, describe in detail the activity to be supported.


Amount of financial contribution requested:______________________________________________

The specific date when the funds are needed:_____________________________________________

Please state your justification of the request for financial contribution in relation to the overall educational mission of the school district

___________________________________________________________________________________
Signature of Person Submitting the Request

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Piute County School District
500 North Main
Junction, Utah 84740
Phone:435-577-2912 ~ Fax:435-577-2561

 

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