Teacher(s):

Grade Level:

Date:

Description of Purchase(s):

Purpose of Purchase(s):

Total Cost of Purchase(s):

Check to be Payable to:

Date Check needed by:

Deadline to submit Enhancement Fund Application form is January 1, 2004

Please return form to: Sandy Dzera-Kyle, POW Treasurer

*K-5, Library, Art, Phys. Ed., and Music = $500 each

*Emotional, Gifted, Instructional, Learning, Math & Reading Support, Language, Speech and Guidance = $200 each