Strategic Impact Grant – Check Request This form is used to request a payment for your Strategic Impact grant. It should be submitted by the Project Coordinator of the grant. Project Coordinator* First Last Email address* Project Title*Grant title as it was listed on your grant applicationSchool*Indicate the school that the grant was designated forDistrictwideDistrict Preschools - allDistrict Preschool - FranklinDistrict Preschool - HopkinsDistrict Preschool - KingArts MagnetCragmontEmersonJeffersonJohn MuirMalcolm XOxfordRosa ParksSylvia MendezThousand OaksWashingtonLongfellowKing MiddleWillardBTABerkeley HighIndependent StudyHerrick HospitalGrant 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.2019-202018-192017-18Amount 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.PersonOrganizationCheck to be made out to:* First Last Check to be made out to organization:*Organization nameAddress 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 mailMail check to payee via district mailMail check to project director via district mailPick up the check at the Schools Fund officeTax Information May Be RequiredIf 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 InstructionsIf you have other special instructions, provide details here.CommentsThis field is for validation purposes and should be left unchanged.