LGA Foundation Form

LGA Foundation Mission: The purpose of LGA Foundation is to provide financial support to enhance the programs of Lionsgate Academy and students on the autism spectrum.

LGA Foundation - Request for Funds

Applicant/Contact Person *
E-Mail *
Phone Number *
Department/Organization *
Project Title *
Amount Requested *
Project Begin Date (MM/DD/YY) *
Project End Date (MM/DD/YY) *
Project Statement Please type your answers to the following questions and attach it with this request form.
Identify the following for the proposed project:
Objective *
Intended Audience *
Number of Participants *
Reasons/Benefits: *
How Does This Project meet the mission statement of the LGA Foundation *

In detail, please describe how the requested funds will be spent: (i.e., cost of material, supplies, services, etc.) Please attach any bids, along with any supporting documentation. *

To whom will the check be made if the LGA Foundation Board approves the funds? *
Date the funds will be needed (MM/DD/YY) *

Note:

Depending on your request, you might be asked to present your project to the LGA Foundation Board at their next monthly meeting. The Board Chair will contact you if this is required and at that time more information will be provided. Please note that if your request is approved, the LGA Foundation, as a certified non-profit, requires a follow up report to verify that the funds were spent in accordance with this request. Individual designated to complete follow up report:

Name *
Phone *
E-Mail *

The report should be a minimum of 1 page, typed and tell us about the impact of the program.
If your project was given more than $300, you must also include at least 3 pictures illustrating the impact of the program. If you are including images of students, please make sure each student pictured has a photo release on file at Lionsgate Academy.
The report is due no later than 1 month after the project end date, as stated above.

As a recipient of funds, I/We agree that all monies received will be used only in accordance with the terms of the proposal and the request for funds grant as provided by the LGA Foundation. *

Please contact me as to when the next Foundation meeting will be. I would like to present this proposal in person.
Upload any additional documents
Select the name the administrator who has approved this proposal. *

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LGA Foundation Form

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