This form contains 33 fields organized into 13 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Approving Administrator's Printed Name and Title
Approving Administrator's Printed Name and Title Text
Enter the printed name and title of the approving administrator.
Approving Supervisor's Printed Name
Approving Supervisor's Printed Name Text
Enter the printed name of the approving supervisor.
Check Mailing Address
Mailing Name and Address Text
Please provide the full name and address where the check should be mailed.
Event Details
Number of Volunteers Number
Enter the total number of volunteers participating in the event or activity.
Event Date and Time Text
Provide the date and time when the event or activity will take place.
Event Location Text
Specify the physical location where the event or activity will be held.
Event Phone Number Text
Enter a contact phone number for the event or activity.
General
Text18 Text
Text19 Text
Text20 Text
Text21 Text
Participant Information
Participant Information Details Text
Provide a detailed list of the children and families served by this event/activity, including the child's name, CYCIS ID#, and the criteria for their selection.
Payment Details
Check Payable To Text
Please provide the name of the entity or individual to whom the check should be made payable.
Amount Requested Number
Please provide the total monetary amount being requested.
Reason for Request
Entertainment Checkbox
Check this box if the reason for the request is for entertainment purposes.
Gifts Checkbox
Check this box if the reason for the request is for gifts.
Space Rental Checkbox
Check this box if the reason for the request is for space rental.
Food Checkbox
Check this box if the reason for the request is for food.
Cost Per Person for Food Number
Enter the cost per person if food is being requested. Fill only if 'Food' is 'Yes'.
Depends on: Food
Vital Records (Birth Certificate) Checkbox
Check this box if the reason for the request is for vital records, such as a birth certificate.
Other Checkbox
Check this box if the reason for the request falls into a category not listed above and requires specification.
Other Reason for Request Text
Provide a detailed description of the other reason for the fund request. Fill only if 'Other' is 'Yes'.
Depends on: Other
Request Objective
Request Objective Text
Please provide a brief description of the event, activity, or reason for this request.
Special Instructions
Special Instructions Text
Please provide any special instructions related to this request.
Sponsor Address
Address Text
Please enter the street address of the sponsoring agency or organization.
City Text
Please enter the city of the sponsoring agency or organization.
State Text
Please enter the state of the sponsoring agency or organization.
Zip Code Text
Please enter the zip code of the sponsoring agency or organization.
Sponsor Information
Sponsoring Agency/Organization Text
Please provide the full name of the sponsoring agency or organization.
Contact Person Text
Please provide the name of the contact person for the sponsoring agency or organization.
Sponsor Phone Numbers
Work Phone Number Text
Please enter the work phone number for the sponsor.
Home Phone Number Text
Please enter the home phone number for the sponsor.
Fax Number Text
Please enter the fax number for the sponsor.