1008 Scope of Work Amendment Request

1008 Scope of Work Amendment Request

This form must be completed by the Lead Applicant.
A change in program is defined as significant modification to instructional programming, content, or structure. This might include program services changing from after school to the summer, changes to program content, or changes to the students targeted. If you are not sure if your modification requires an amendment, continue to complete this form and we will follow up if more information is needed.

The last date to submit an Amendment request will be 03/31/2022 for single-year and 04/15/2023 for multi-year grantees to ensure sufficient review time.
Name*

First NameLast Name
Email*
example@example.com
Organization Name*
Will the Change in Scope require any change in budget? (A change in budget is considered a difference of 10% or more on any line item. If yes, this will require a budget modification. Please complete the Jotform for budget modification instead.)*

YesNo
Please select a reason for change in scope.*

Change in service due to COVID concernsChange in programming (e.g. from math to reading instruction)Change in number of students served if greater or less than 25%Change in program schedulingOther
Please describe the Change in Scope Request below. Include the original scope from your application, and detailed justification for the change in scope. (If this section does not include enough information, there may be delays in processing your request for amendment.)*
Should be Empty: