GNSI Education Fund Disbursement Request Form
________________________________________________________________________
Project (Program, Activity, Resource)
Title______________________________________________________________________________
Date and Time (If Applicable) _________________________________________________________
Location __________________________________________________________________________
I have received:
[ ] approval of Education Fund funding in the amount of $________.
[ ] partial funding in advance in the amount of $_______.
I have attached the following required items for disbursement:
[ ] final report
[ ] receipts for all previously approved expenses
[ ] summary/review of the sponsored program, to be submitted to the GNSI Newsletter
Applicant signature ___________________________________________ Date
Send request form and required items to the Education Fund Director (check with GNSI for current contact information).
Revision 03.14.06
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