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WORLD LANGUAGE TRIP Grant Request
Grant Payment Application
*
1.
Requestor
Information
(Required.)
Your Name:
Your Title or Position:
Request Date:
Destination of Trip:
Dates of Travel:
Cost of Trip:
*
2.
Student Beneficiary
Information
(Required.)
Name:
Date of Birth:
Current Grade in School:
Grade at Time of Travel:
*
3.
Has the student earned a grade of "C" or better in all language courses for this trip?
(Required.)
Yes
No
By initialing here, I am verifying that I have personally checked all grades, and that they meet a "C" or above (Requestor, please initial):
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4.
How many courses in this language will the student have taken prior to Trip departure?
(Required.)
One (1)
Two (2)
Three (3+) or more
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5.
Please provide evidence (signed permission slip or letter granting permission) of parental support of student participation in World Language Trip.
(Required.)
Choose File
No file chosen
*
6.
Please confirm the student has a valid passport, visa, or any other required travel documentation necessary to participate in this Trip.
By initialing below, I am confirming that the student has the required documentation to travel.
If travel documentation is not currently available, PCF will provide a determination letter for this grant request, but will not release funds until a satisfactory review of documents can occur.
(Required.)
Yes
No
By initialing here, I am verifying that I have personally confirmed that the student has the required travel documents OR will be securing them before the proposed travel date (Requestor, please initial):
