FUNDRAISING REQUEST FORM Exhibit 374

Wautoma Area School District
Approved 04/19/79
Revised 02/10/00

Instructions: All fundraising requests shall be placed on the first Board meeting agenda in October. Any groups planning activities in the month of August, September, or early October must have their activity approved at the first regular Board meeting in October during the previous school year. The group advisor must complete this form. Incomplete forms shall be returned. If you have any questions please refer to the policy and consult your building administrator.

Group:
Advisor:
Student Treasurer:
Budget for the current school year:
Beginning Balance:
Beginning Balance $
Anticipated Expenditures Amounts
Ending Balance $

Describe and/or list the plan of the projected fundraiser (must include whether the activity will be one of selling a commodity or service, soliciting for contributions, tickets for some type of entertainment, other kind of activity):

Will students and/or parents be involved in this fundraiser outside of the school building? Yes No
(If yes, Board approval is required)

Does this activity or group receive District funding support? Yes No
If yes, enter amount:

Date requested for fundraiser:

Length of time fundraiser will be conducted:

Are you willing to accept a Board assigned date for this activity if one or more activities are in conflict with one another? Yes No

Signature of Advisor Date