Reapplication PASP Form

Please provide a summary of the prior award period, including program outcomes, population served, significant financial variances, challenges encountered, sustainability plans, and expected outcomes if additional funding is awarded:

CERTIFICATION
By submitting this application, the director or other individual with authority to bind the Organization, and the Organization’s Board of Directors or other governing body, hereby certify that they (1) have approved the submittal of this application, (2) all information is accurate and complete to the best of their knowledge, (3) the timing of the project as described will be met, and (4) the Organization is in compliance with all applicable state and federal laws and regulations to the best of their knowledge.
If awarded funding, your organization must sign and return the award agreement within 30 days or funding may be forfeited.
Signature:
Printed Name:
Title:
Date:
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REAPPLICATION PASP (Partner Agency Scholarship Program) FORM