The Bergen Pac Community Fund
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1The Bergen PAC
Request n._____/______
Community FUND
Please return to
Blue PAC box
OR
Application Form for Funding
info@europeanschool-parents.nl
For the attention of the President of the PAC
1. Person responsible for the request:
Parent
Management
Teacher
PAC
Pupil Rep.
Name of person:
þÿ
Email address:
þÿ
Date of request:
/
/
(dd/mm/yyyy)
þÿ
þÿ
þÿ
2. Description of the project:
Kindergarten
Primary
Secondary
Which classes:
þÿ
Number of adults involved:
Number of children involved:
þÿ
þÿ
Description / Objective (max. 700 characters):
þÿ
3. Total Cost:
Specify amount: €
Approximate
Exact
þÿ
Details (max 350 characters):
þÿ
4. Date of event:
/
/
(dd/mm/yyyy)
(to
/
/
)
þÿ
þÿ
þÿ
þÿ
þÿ
þÿ
5. Payment details:
invoice / name of supplier
þÿ
6. In filling in this form, it is acknowledged that you have read and accepted the Bergen PAC
Community Fund rules and to have agreed that within one month of receiving the funding to provide
the PAC with photos and a short report of the project (preferably in En, Nl and Fr) which the PAC can
then use for their communications.
I apply for a funding:
þÿ
Signature: _______________________________
7. Please supply if necessary (on an extra sheet) any further information that might be of relevance.
8. Approval by management:
9. Approval by PAC:
Date: ___ / ___ / ______
Date: ___ / ___ / ______
Signature:__________________________
Signature:__________________________
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