NEWIL Education Grant Form

Educational Grant Application Form

Name :	Library Name Date:
Address :
City:	State Email
Phone :
Title of Activity :	Activity Date:
Describe grant request :

List anticipated expenses: (Grants are a 50/50 match. Please review Guidelines.)

Registration:	Request from NEWIL
Mileage:	Local Matching Amount
Lodging :	Total:
Meals :
Other :
TOTAL :

Supervisor's Name at Library Institution

Reimbursement check should be addressed to: (Library or Individual's Name)

I understand that I must submit receipts for my expenditures at this activity before receiving payment.I also agree to share information from this experience with my colleagues in NEWIL. Receipts should be sent to: NEWIL, 515 Pine St., Green Bay, WI 54301.
, (920)448-4413 if more information needed.