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    2017-2018 PTA
    PROGRAM BUDGET REQUEST FORM

    INSTRUCTIONS: Fill out this form to request a budget for a PTA program for the 2017-2018 school year. Please use a separate form for each program for which you are applying. Return the completed form to the PTA treasurer box or email it to the PTA co-treasurers: westwoodlandtreasurer@gmail.com

    DUE DATE:    Tuesday, March 28th
    For NEW programs, please turn this form in as early as possible.

    1. Name of the Program, Event or Activity: ___________________________________________

    2. Is this budget request for a new or existing PTA-sponsored program? (circle one)

    3. Briefly describe the purpose of this program: ________________________________________

    4. List the program coordinator and other contact person(s) for this program. You must include a program coordinator for this program to be considered!

    Role
    (e.g., Program Coordinator)
    First & Last Name Phone # Email
           
           

    5. Please describe the types of program expenses and estimated total program cost for the 2017-2018 school year:

    Expense Type
    (e.g., supplies, teacher fees)
    Expense Description Cost ($)
         
         
         
         
    TOTAL ESTIMATED COST OF PROGRAM FOR 2017-2018 SCHOOL YEAR:  

    6. Please outline any funding sources (other than the PTA) that you expect to receive for your program (if none, leave blank):

    Source
    (e.g. donation, grant, tuition)
    Description Income ($)
         
         

    7. Total funding amount requested from the PTA for the 2017-2018 school year (less any funding you noted in Question 6):

    $____________

    8. Please add any comments or additional information here (you may also use the back of this page) and staple any pertinent information to this form: