Funding Application Cover Sheet - North Dakota State Government
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1th
State Capitol 15
Floor
FUNDING APPLICATION COVER SHEET
600 East Boulevard Ave Dept 270
Department of Career and Technical Education
Bismarck ND 58505-0610
SFN 15274 (11/14)
Phone 701-328-3180
Fax 701-328-1255
Title of Program/Project
CTE Use
Program #
Proposed Starting Date
Request Type
New Program
Transfer of Program Funding
Fiscal Agent
Address (City, State, Zip Code)
Project Contact Person
Phone
Email Address
Location of Project
Address (City, State, Zip Code)
The signature assures that the applying agency does not advocate, permit, nor practice discrimination on the basis of sex, race, color,
national origin, religion, age, or disability as required by various state and federal laws.
Signature of authorized official of applicant organization verifies that the necessary legal authority to apply for and to receive funding for
the proposed activity.
________________________________________
__________________________________
________________________
Authorized Official (Please print or type)
Title
Phone
____________________________________
________________________________________
________________________
Email Address
Signature of Authorized Official
Date
For instructional programs to be funded by the North Dakota Department of Career and Technical Education, please
attach the following:
A. A project description stating the intent of the project and how it aligns with the program standards of the CTE.
B. A statement of need, which includes the methods by which the need was identified.
C. A list of measurable project objectives.
D. Funding Application Budget form (SFN 15275).
Note: The title of the proposed project must be listed at the top of each attached page.
CTE Use
Approved
Disapproved
Amount
Percent
Comments___________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
_______________________________________________
____________________
Signature of Supervisor
Date
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