Safety Grant Application

Safety & Loss Prevention Grant Program Application

(*) Required Field

District *
Applicant *
First Name
Last Name
Phone * (### ### ####) no dashes

Email *
Purchase Info
$200 Minimum
Purchase Amount *

Date of Purchase *
Month (MM)
Day (DD)
Year (YYYY)
Description of materials or services purchased *

Please describe how this purchase will help improve safety or prevent a covered loss from occurring. *

Receipts/Invoice

Attach receipt(s) and/or invoice(s) here. Note that you may combine multiple purchases and invoices into a single grant application by uploading multiple invoices below or combining your PDFs into a single file. When combining applications, be sure to include descriptions and explanations of the expected benefits for each good or service purchased.
Upload File(s)