Grant Recipient Reimbursement Form

NOTE Before you begin, please ensure you have the following:

All receipts that match your approved budget, in digital form, ready to be attached.
Your building account code.
If you don’t have it, ask your building administrator for the account number.

Without these two items, the Foundation cannot reimburse your school.

Multiple receipts are not uncommon.

Funds will not be reimbursed if submitted after March 31st!

Congratulations!!!!

Please fill out all of the following fields and submit ASAP. The Dickinson Public Schools Foundation cannot issue payment for this grant until the information is received.

Name(Required)

First Last

Which Grant did you receive?(Required)

Annual Grant

Mini Grant

Sponsorship Grant

Personal Phone(Required)

Email(Required)

Name of Project

Building(s)

Building Administrator

Building Account Number(Required)

Ask your building admin, this is required and should look like this: 06.00.014.400.3430.600

Amount Approved by DPSF(Required)

TOTAL amount requested for reimbursement(Required)

If your receipts total less than your approved budget, provide the actual total of your receipts. If you spent more than approved, enter the grant budget that was approved.

Write a brief summary of what this grant means to you and your students or school? Include future plans if applicable.(Required)

ATTACH FILES

Include ALL project receipts

Receipts Attached HERE(Required)

Drop files here or

Max. file size: 256 MB.

DID YOU ATTACH EVERYTHING?

All parts are required in order for the Dickinson Public Schools Foundation to issue a check to your intended school. You MUST attach receipt files today and photos will be requested for your follow up report.

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