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HTML Preview Fax First Page page number 1.
1
The Impact
Aid Pr
ogram
G5
e
-
APPLICATI
ON COVE
R SH
EET
IMPACT AID
PROGRAM
FY 20
1
5 -
SECT
IO
N 80
0
3
Fax
TO:
Impact Aid Program
SCHOOL DISTRICT N
AME
:
FAX:
1-
866
-
799
-
1272
IMPACT AID NUMBER
:
CONTAC
T NAME
:
CONTACT
PHON
E:
COMMENTS:
Use this c
over page
to fa
x
your
e-
Applicati
on sign
ature page
s by
January
31
, 201
4
. These doc
uments
must be
signed an
d dated on
or bef
ore the
January 31
, 201
4
due dat
e. Remember to
keep your f
ax
confirm
ation sheet
showing the d
ate and time s
ent.
Filled o
ut Fax Co
ver Page
Signed and D
ated
Applic
ation
Cover
Page
Signed and D
ated Assuranc
es Page
• U.S. Dep
a
rtmen
t
of
Ed
ucation •
Office
of Elementary and Seco
ndary Educa
tion • Impact Aid P
rogram •
400 Maryland Avenue S.W
. Washington, DC 20202
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My son is now an ‘entrepreneur’. That’s what you’re called when you don’t have a job. | Ted Turner