CPL Fund Request Form

CPL Grant Application Form

PART A: To be completed by the APPLICANT

Name:_______________________________________ Date of Request:____________

Address:_____________________________________ Date of Event:______________

City, State/Province, Zip/Mail Code:___________________________________________ E:mail:________________

Amount of Request:___________________ Check payable to:_______________________

Send check to:_________________________________________________________________________________

Are matching funds available? Yes No

Are receipts attached? Yes No Is a budget attached? Yes No

Please describe your activity in three or four sentences. Explain how this activity will promote Latin in your community. If appropriate, mention how you plan to publicize this activity. A more detailed description and supporting materials can be attached, if necessary.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Send this form, with all attachments, to your CAMWS State Vice President. Thank you very much!

PART B: To be completed by the STATE VICE PRESIDENT

Is applicant a current member of CAMWS? Yes No (If uncertain contact Susan L. Tucker [sltucker@rmc.edu].)

Approved Denied Comments: ____________________________

Date:____________________________ Signature: _____________________________

PART C: To be completed by the REGIONAL VICE PRESIDENT

Approved Denied Comments: ____________________________

Date:____________________________ Signature: _____________________________

PART D: To be completed by the CHAIR OF CPL

Approved Denied Comments: ____________________________

Date:____________________________ Signature: _____________________________

PART E: To be completed by the SECRETARY-TREASURER of CAMWS

Check #:________________ Amount:________________ Date Mailed:________________

NOTE: This website is maintained by CPL Chair, Tom Sienkewicz, at Monmouth College, Monmouth, Illinois. If you have any questions, you can contact him at toms@monm.edu.

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