Strategic Impact Grant - Check Request - Berkeley Public Schools Fund

NOTICE - CHANGES DURING SCHOOL CLOSURES / COVID-19

During school closures, we will be disbursing checks only for the reimbursement of amounts already paid out-of-pocket OR for urgent needs due to school closures / COVID-19. Because of the uncertainty regarding the duration of the school closures and what the rest of the school year will look like, we will not be paying for future activities at this time. Please email us at schoolsfund@berkeley.net if you have any questions.

What type of payment are you requesting?*

Please indicate what type of payment this is. If none apply, select Other and describe the reason you are requesting payment.

Reimbursement for out-of-pocket expenses already made
Urgent need due to COVID-19
Future expense - describe below
Other

Description of Reimbursement, Urgent Need, Future Expense, or Other type of payment*

Please describe the reason for this payment.

Project Coordinator*

First Last

Email address*

Project Title*

Grant title as it was listed on your grant application

School*

Indicate the school that the grant was designated for

Grant number*

Enter grant number as specified in the email you received about your grant award (e.g. 1-751)

School Year for this grant*

Please enter the academic year that this grant was awarded for.

Amount of this payment*

Specify the amount of this payment. DO NOT INCLUDE $-SIGN OR COMMA.

Is check payable to a person or an organization?*

Specify whether the check should be written to a person or to an organization.

Check to be made out to:*

First Last

Check to be made out to organization:*

Organization name

Address of payee:*

Street Address City State / Province / Region ZIP / Postal Code

Email address of payee*

We need to have payee contact information in case we have any questions for them.

Phone number of payee*

We need to have payee contact information in case we have any questions for them.

Where should we send the check?*

We can mail the check directly to the payee, send it to you at your BUSD location (so you can give it to payee), or hold the check for pickup in our office.

Mail check to payee via US mail
Mail check to payee via district mail
Mail check to project director via district mail
Pick up the check at the Schools Fund office

CHECKS WILL BE MAILED VIA US MAIL - we are working remotely.

Tax Information May Be Required

If the payee is an individual that is being paid for their services, then we require their tax ID number (unless we already have that on file). Please either have the payee contact us with their information or complete an IRS W-9 form (just Google "IRS W-9 form" to find a fill-in form) and return it to us. We cannot make payment without this information.

Receipts or other payment documentation*

Depending on the type of payment, different documentation is required. When payment is for reimbursement, copies of receipts should be sent to the Schools Fund by either email or district mail. For payment to an individual for services, or to a company for products or services - send a copy of any invoice or email with payment instructions.

Reimbursement - send copies of receipts to Schools Fund
Payment to individual for services - send copy of invoice or email with payment instructions
Payment to an organization - send copy of invoice or email with payment instructions

Additional Payment Instructions

If you have other special instructions, provide details here.

Name

This field is for validation purposes and should be left unchanged.