AD LUCEM GRANT APPLICATION FORM
APPLICATION FORM FOR SUPPORT AND FUNDING
AD LUCEM FUND
A fund set up to enable the support of Napier Girls High School Girls for funding to Provincial and National honours.
Name of person completing application: _________________________________________________
Name of Cultural or Sporting Team: ____________________________________________________
Teacher /Parent in charge:________________________________Phone:______________________
Summary of reason for funding application and what the funds will be applied to: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What fundraising has been done towards your trip? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Have you applied for a grant from us before? If so when and how much did you receive? ____________________________________________________________________________________________________________________________________________________________________
SIGNED: DATED:
CONFIRMATION FORM
Name of Applicant/s_________________________________________________________________________
This confirms that your application to the AD LUCEM FUNDhas been considered by the Napier Girls High School PTA and a grant has been given.
Total Approved: $_______________________ (cheque no:......................attached)
Payment for Term: ONE TWO THREE FOUR
Dated: / /
Signed and Approved by:
President: Name:
Treasurer: Name:
Secretary or Committee Member: Name:
Principal or Deputy Principal: Name:
This confirms that your application to the AD LUCEM FUND has been considered by the Napier Girls High School PTA and we regret that your application was unsuccessful this term.
Please feel free to re-apply in the future.
Signed: President
Dated / /