The Pennsylvania State Council VVA Grant Request Form can be filled in on your computer and printed out.  Click on the underlined link above to obtain the forms. 

There are four sections to the grant: Grant Request, Grant Request Detail, Request for Final Payment and Final Payment Project Summary.

Chapter                   Phone

Name of Project      Amount Requested

Brief Description of Project

Grant is for use by:  Chapter    Individual

Request Approved by Chapter Board   

Date     

Signature of President or Treasurer

Requested Method of Payment:  Single   Monthly   Quarterly   As Billed

Pay To   Address

City    State     Zip

To be completed by State Council

Date Received by Finance Committee    Amt. Recommended by Finance Committee $

Date Received by Executive Committee    Amt. Recommended by Executive Committee  $

Date Approved by State Council     Amount Approved by State Council  $

Pennsylvania State Council Vietnam Veterans of America Grant Request Detail

Chapter   

Project

                                                              Total Project Revenues and Expenses

Revenues                                                                                              Proposed Grant                      Previous Project

            Grant Requested                                                        $ $

            Chapter Funds                                                            $ $

            Other Sources (specify)                                            $ $

                                                Total Receipts                         $  $

Expenses

            Rent                                                                              $ $

            Travel                                                                           $ $

            Registration Fees                                                      $ $

            Postage                                                                        $ $

            Telephone                                                                    $ $

            Other (specify)                                                            $ $

                                                Total Expenses                        $ $

Additional Comments

Pennsylvania State Council Vietnam Veterans of America Request for
Final Payment

Requested by                                   Date  

Chapter                                 Phone

Name of Project                   Amount Requested

Reconciliation

Total Expense, per detail                                                                                                     $           

Less, Total Chapter and Other Funds Utilized                                                               $

Net Grant Costs                                                                                                                    $

Total Grant Authorized                                                                                                       $

Lesser of Net Grant Costs or Total Grant Authorized                                                 $

Total Grant Payments Received                                                                                        $

Final Payment Requested (must agree with above)                                                        $

Check Number                    Date

Payee

Address                           

City               State             Zip

Debit:   Account          Amount                                                                                                                                                                                                                                                                                                            

Credit:  Account         Amount

Notes:

Pennsylvania State Council Vietnam Veterans of America
Final Payment Project Summary

Chapter 

Project   

Total Project Revenues and Expenses

Project Revenues

            Grant Approved                                                                                                  

            Chapter Funds                                                                                                    

            Other Financial Sources (specify)                                                                 

                                                                                                         Total Receipts       

Project Expenses (please list all related expenses and the actual cost)

$

$

$

$

$

$     

                                                                               Total Expenses    

        Excess of Receipts over or under the Projected Expenses