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Series 703.5.2P - Grant Application Summary (Grant Valued at $500 or More)

Adopted: May 2012
Revised: September 2012


Complete this grant application summary for any grant valued at $500 or more and for all state and federal grants. Attach the completed summary to a copy of your grant application and submit it to the director of finance and operations.

Check here if School Board approval is required as part of the grant application. Allow enough time for the application to be approved by the board; the School Board meeting schedule is available at

Print or Type

Grant name                                                                                                           

Name of organization sponsoring the grant                                                              

Grant application amount $                      Grant application date                    

Brief description of grant                                                                                                                                                                                                                                                                                                                                                  

Name of school/department/program that will benefit from the grant                                                                                                                                                      

Name of grant applicant                                           Position                                   

Email                                                   Phone number                                           

Submit this completed form and the grant application to:

Director of Finance and Operations

Independent School District 196

District Office

3455 153rd Street West

Rosemount, MN  55068

Questions:  651-423-7715


Finance use only

Director approval___________________________           

Return to Director of Finance and Operations

Date received_________________________________            Grant application awarded □ yes □ no

Summary to Supt Office______________________            Board exhibit date if required ___________________   

Grant application filed in Finance____________            Revenue account code___________________________

Retention date_______________________________