WVHEA
West Virginia Home Educators
Association
P.O.
Box 4241
Clarksburg,
WV 26302
Phone 1-800-736-WVHE (9843)
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WVHEA
West Virginia Home Educators
Association P.O.
Box 4241 Clarksburg,
WV 26302 Phone 1-800-736-WVHE (9843) |
Regional Outreach and Development Grant
Application
Name
of WVHEA Member_______________________________________
Address_______________________________________________________
(Street
or P.O. Box)
_____________________________________________________________
(City/State/Zip)
(County)
Phone_________________________E-mail__________________________
Date
and time of event___________________________________________
Location/address
of event ________________________________________
_____________________________________________________________
Briefly
describe event/project and amount requested, $500
maximum per request. (May
attach additional sheets as necessary.)
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Please
explain how this project or event is consistent with WVHEA purposes as stated in
the Constitution and By-laws.____________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Contact
person (if other than applicant)______________________________
Address
(if other than applicant)___________________________________
(Street
or P.O. Box)
_____________________________________________________________
(City/State/Zip)
(County)
Phone_________________________E-mail__________________________
If
children are involved please describe supervision provided____________
_____________________________________________________________
_____________________________________________________________
Anticipated
cost to WVHEA members____________ others_____________
Please attach a detailed budget for
entire project, with an estimate of fixed and variable expenses and income along
with any anticipated fees to be charged for participation and discounts for
WVHEA members.
Mail
completed application to: WVHEA,
P.O.
Box 4241 Clarksburg, WV 26302
Questions?
Please call 1-800-736-9843 or email newinfo@wvhea.org.
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For
Office Use
Date
application received:____________________
Scheduled for review: _______________________
Received
by:___________________________________________________________________________