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Private Schools - Expenditure Request

ALL EXPENSES FUNDED THROUGH FEDERAL PROGRAMS MUST BE

REASONABLE, NECESSARY AND ALLOCABLE.

Name of Requestor: *

Email Address: *

School *

Describe the purchase/expenditure: *

Explain why this purchase is necessary to improve student achievement or the quality of education for your students: *

What evidence or research supports the effectiveness of this purchase? *

Which program fund is being requested? *

Title I
Title II
Title IV

If these funds were not available, would you use private school funds to pay for this product/service? *

Yes

Is this request neutral, secular and non-ideological? *

Yes

Projected Costs:

Must provide documentation for all related expenses

Product/Service Cost, if requested:
Be sure to include all related expenses (fees, shipping, etc.)

Description	Qty	Total Cost



Total

Travel Cost, if requested:

Registration	Total Miles	Mileage Reimbursement (Rate $0.70/mile)	Hotel	Meals ($68 w/ overnight stay)	Other	Total

Other Expense: Please specify:

Total Cost Requested: (Number) *

Cost of comparable quote (if applicable): (Number)

Required Attachments:

Please attach all documentation and comparable quotes to this request. Be sure to include all related expenses (registration fees, products, shipping/handling, travel, services, etc.)

Quote:

List of Allowed file types

Comp Quote:

List of Allowed file types

Professional Development Information:

List of Allowed file types

Map - Must include address using the shortest reasonable route:

List of Allowed file types

If overnight stay is requested, please include hotel information:

List of Allowed file types

Requestor Signature:

Failure to attend an event will require reimbursement to BWSD by the requestor for anything prepaid.

Type your name and sign below

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Administrator's approval confirms this expenditure is neutral, secular and non-ideological.

The Administrator's Handbook on EDGAR: 76.658 states:

(a) A subgrantee may not use program funds to finance the existing level of instruction in a private school or to otherwise benefit the private school.

(b) The subgrantee shall use program funds to meet the specific needs of students enrolled in private schools, rather than:

The needs of a private school; or
The general needs of the students enrolled in a private school

Approvals

A number of approval stages need to be completed before this submission can be accepted.

Private School Administrators

Please select the appropriate approvers from the Private School Administrators group below.
Please select your principal/supervisor

Our Lady Academy

St. Stanislaus

Holy Trinity

Federal Programs Director

Appropriate approvers from the Federal Programs Director group will be automatically allocated for this approval stage.