MCR20-016 05/20
BUDGET REQUEST DETAIL
Please type or print; attach additional sheets as needed or use the Excel Budget Form found on the AHS website, azhs.org.
Name of Organization _______________________________________________________________________________
Project Title ________________________________________________________________________________________
**REFER TO THE AHS GRANT CRITERIA & GUIDELINES**
A MATERIALS, SUPPLIES, EQUIPMENT TO BE PURCHASED OR RENTED:
ITEM
QUANTITY
(A)
COST PER UNIT
(B)
EXTENDED COST
(A x B=C)
TOTAL MATERIALS AND SUPPLIES EXPENSES
B PERSONNEL: Paid staff, intern, student stipend, or volunteer time (Note: Volunteer time is valued at $25.43/hr)
NAME, TITLE/ROLE HOURS (A)
HOURLY RATE
(B)
AMOUNT
(AxB)
$
$
$
$
TOTAL PERSONNEL EXPENSE $
C PROFESSIONAL SERVICES: Outside consultant or contractor
COMPANY NAME AND ADDRESS TYPE OF SERVICE AMOUNT
$
$
$
$
TOTAL PROFESSIONAL SERVICES $
D OTHER DONATIONS AND GRANTS RECEIVED
DONOR NAME AMOUNT
$
$
TOTAL OTHER DONATIONS AND GRANTS $
BUDGET SUMMARY
DESCRIPTION EXPENSES
A = TOTAL MATERIALS EXPENSE
$
B = TOTAL PERSONNEL EXPENSE
$
C = TOTAL PROFESSIONAL SERVICES EXPENSE
$
TOTAL PROJECT COST (A + B + C) $
LESS OTHER DONATIONS AND GRANTS RECEIVED (– D) $
TOTAL UNCOVERED PROJECT EXPENSES (=) $
AHS SMALL GRANT REQUEST AMOUNT* $
*NOTE: Amount cannot exceed $2,000 for Tier 1 Certied Institutions, and $1,000 for Tier 2 Certied Institutions.
SUBMIT BY JULY 31, 2020
Email completed form to: certied@azhs.gov
Or mail to: Arizona Historical Society | 1300 N. College Ave. | Tempe, AZ 85281
For questions, please call (480) 929-0292.
Certified Historical Institutions | Budget Details
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