WORLD LANGUAGE TRIP Grant Request

Grant Payment Application

Question Title

1. Requestor Information (Required.)

Your Name:

Your Title or Position:

Request Date:

Destination of Trip:

Dates of Travel:

Cost of Trip:

Question Title

2. Student Beneficiary Information (Required.)

Name:

Date of Birth:

Current Grade in School:

Grade at Time of Travel:

Question Title

3. Has the student earned a grade of "C" or better in all language courses for this trip? (Required.)

Yes

By initialing here, I am verifying that I have personally checked all grades, and that they meet a "C" or above (Requestor, please initial):

Question Title

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

Question Title

5. Please provide evidence (signed permission slip or letter granting permission) of parental support of student participation in World Language Trip. (Required.)

Question Title

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

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):

Question Title

* 1. Requestor Information (Required.)

Question Title

* 2. Student Beneficiary Information (Required.)

Question Title

* 3. Has the student earned a grade of "C" or better in all language courses for this trip? (Required.)

Question Title

* 4. How many courses in this language will the student have taken prior to Trip departure? (Required.)

Question Title

* 5. Please provide evidence (signed permission slip or letter granting permission) of parental support of student participation in World Language Trip. (Required.)

Question Title

1. Requestor Information (Required.)

2. Student Beneficiary Information (Required.)

3. Has the student earned a grade of "C" or better in all language courses for this trip? (Required.)

4. How many courses in this language will the student have taken prior to Trip departure? (Required.)

5. Please provide evidence (signed permission slip or letter granting permission) of parental support of student participation in World Language Trip. (Required.)