Community Unit School District No. 1
8:80 E1
Community Relations
Gifts to the District
Application Form for Donations, Memorials, and Artifacts
Name of person submitting the form: __________________________________________________________
Date submitted: ______________________ Is this a donation to honor someone?
Yes
No
If yes, write the person’s name and attach a narrative outlining his/her contributions to CUSD #1
Name of person being honored: _______________________________________________________________
Proposed donation: (type, location, description, size, etc.)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Attach a rough sketch of the donation and its placement if necessary
___________________________________________________________________________________________
Building Principal:
Recommend ______
Not Recommend ______
Please state the reason(s) for a negative recommendation or any modifications that you would like the committee
to consider.
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Committee Action:
Recommend ______
Not Recommend ______
Recommend with the following modifications:
_________________________________________________________________________________________
_________________________________________________________________________________________
ADOPTED: September 16, 2009
8:80 E1
Page 1 of 1