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Community Fund Form 

Personal Information 

Person/Group Requesting Funds  
W # (preferred) or SSN  
Extension  
CPO  
 

Request Information 

Approximate Amount Being Requested  
Have you previously requested community funds this school year?
 

If so how much?  
Please briefly describe use of previous funds below.

 
Person or Agency receiving Funds/Materials  
 
Please briefly explain how this money will benefit the community.
 
 
Item Quantity Cost per Item (Estimated Cost) Total