In-Service Continuing Ed Grant Application Form - Colorado
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1
2
3In-Service Continuing Ed
Grant Application
Updated: 1/2016
Total Amount Requested
*Submit completed applications to
0.00
$ _____________
postgrants@coag.gov*
Applicant Information
Agency Name: _________________________________________________ Federal ID #: _____________
Chief Executive Name: __________________________________ Phone #: (____) ______-________
Agency Mailing Address: __________________________________________________________________
__________________________________________________________________
Physical Address if different: ________________________________________________________________
________________________________________________________________
Contact Person For This Grant: _____________________________________________________________
Contact Phone #: (____) ________-________
Contact Email: ______________________________________
Type of Grant Requested (more than one box can be checked)
Equipment
On-line subscription
Training Fee (hosting a class)
Backfill
Scholarship ( to include: tuition, hotel, per diem, airfare, gas, rental car)
**Prioritize your requests, with 1 being the highest priority**
Training Equipment Requested: (submit detailed quote)
Priority #: ____
Product Name: ____________________________________________________
Model #: ___________________
Quantity: _________
Individual Item Cost: $ ___________________
0.00
Total Cost: $ ____________________
Priority #: ____
Product Name: ____________________________________________________
Model #: ___________________
Quantity: _________
Individual Item Cost: $ ___________________
0.00
Total Cost: $ ____________________
Priority #: ____
Product Name: ____________________________________________________
Model #: ___________________
Quantity: _________
Individual Item Cost: $ ___________________
0.00
Total Cost: $ ____________________
Priority #: ____
Product Name: ____________________________________________________
Model #: ___________________
Quantity: _________
Individual Item Cost: $ ___________________
0.00
Total Cost: $ ____________________
Priority #: ____
Product Name: ____________________________________________________
Model #: ___________________
Quantity: _________
Individual Item Cost: $ ___________________
0.00
Total Cost: $ ____________________
0.00
Total Cost of ALL Equipment: $ ______________
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Parent category: Legal