Central/Liberty PTO Grant Request Form

Date:  _______________________________________________

Requestor’s Name: ____________________________________

Subject/Grade: _______________________________________

School: ______________________________________________

Amount Requesting: ___________________________________

ATTACH 3 QUOTES OF THIS ITEM

Item Requested and Reason for Request: ____________________________________________________

____________________________________________________

____________________________________________________

Signature:  ___________________________________________

Office Use:

Date:  _______________________

Approved _____     Denied ______

Amount Approved:  ___________________________________

President’s Name: ______________________________________ 

President’s Signature:  __________________________________

Treasurer’s Name:  _____________________________________

Treasurer’s Signature:  __________________________________