SOUTH DAKOTA

 

2007-2008 TRAINING

 

TRAINING GRANT APPLICATION

 

 

For more information or help applying, contact:

Randy Maddox

Training Coordinator

South Dakota Office of Emergency Management

(605) 773-4108

 

 

APPLICATION DEADLINE:       At least 45 days prior to the training event

 

Send application to:

 

                                    South Dakota Office of Emergency Management

                                    Attention:  Randy Maddox

                                                      118 West Capitol Avenue

                                                      Pierre, South Dakota 57501-2000

 

 

           APPLICANT:  _____________________________________________

 

                        ___________________________________________COUNTY

 

                        CONTACT NAME:  ________________________________________

 

                        AGENCY:  _______________________________________________

 

                        ADDRESS:  ______________________________________________

 

                        CITY:  ______________ STATE:  ______ ZIP CODE:  ____________

 

                        PHONE (DAY):  ___________________________________________

 

                        E-Mail Address: ___________________________________________

NON-SUBMISSION OF ANY ITEM MAY DELAY YOUR APPLICATION

 

 

 

2007-08 TRAINING GRANT PROPOSED BUDGET

Start Date:________

 

 

CLASS:

_____________________________________________________                  

End Date: ________

 

 

Brief Class

Description:

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION:

______________________________________________________________  

 

 

 

INSTRUCTOR:

______________________________________________________________

 

 

 

 

______________________________________________________________

 

 

 

 

 

 

 

 

Expected Number of Participants

_________________

 

 

 

Budget Information

$

 

 

 

Instructors fees

 

 

 

 

Instructors mileage costs if applicable

 

 

 

 

Instructors per diem costs if applicable

 

 

 

 

Instructors lodging costs if applicable

 

 

 

 

Class Room Rental fee if applicable

 

 

 

 

Books if applicable

 

 

 

 

Equipment and Supplies

 

 

 

 

Volunteer time:   XX students @ 12.76 / Class Room Hour / Student   

 

 

 

 

Other (Specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                                      Project Total Cost

 

a

 

 

                                                                       Soft Match funds from above

 

b

 

 

                                                                           Hard Match (IF NEEDED)

 

c

 

 

                                                     Grant Request Amount (a-b-c)

 

 

 

 

 

 

 

 

Name, Title and Signature of Course Sponsor Authorized Person:

 

 

 

 

 

 

 

 

NAME (PRINT): 

___________________________________________

 

 

 

 

 

 

 

 

SIGNATURE:

____________________________________________

 

 

 

 

 

 

 

 

DATE:

____________________________________________

 

 

 

 

 

 

 

 

TITLE:

____________________________________________

 

 

 

 

 

 

 

 

I certify that all information given in this grant application is true and correct and that all funds

 

 

 

distributed to the above applicant will be used solely for the project and purposes described in this grant application.