Mini-Grant Form

Application for PTSA Mini-Grant Funding

Instructions: Please type your answers on a separate sheet of paper, or print clearly on this form.  Do not leave questions blank.  Mini-Grant requests are only available to PTSA members.  Forms are available on our website.  If you would like to further explain your request, you are welcome to attend our next executive or general membership meeting.  Just note that you would like to attend on this form and we will email you the next meeting date. * Please note that there is a maximum mini-grant amount of $500.00.  If you would like to implement a program that will exceed $500, please let us know and we can meet to discuss.  All final decisions will be made by the PTSA executive committee.


Date:________________          If you need funds by a certain date, please note date_______________


Department/Subject Area/Teacher Name:



Title of Project:



Statement of Purpose:



How does this address the Learning Standards within your subject area?   What are you goals and Objectives?:



How will you evaluate your project or use of requested materials? What criteria will you use to measure progress toward goals and objectives?:



Give a detailed list of expected expenditures for this project:


________________________                         ____________________                ____________________
Teacher’s Name (please print)                        Teacher Signature                           Shawn C. Petretti, Principal


Please deliver completed applications to Lisa Bieber, place in the PTSA mailbox in the mail room or mail application to PTSA Mini-Grant Committee, PO Box 250, Mattituck, NY  11952

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