Intake Form - Private Schools, Stipends and Fee Payments

Intake Form - Private Schools, Stipends and Fee Payments

Private School Services, Stipends, Fee Reimburse.

Requested Board Date*

This date must be at least 8 weeks from the intake submission date. You can access the board dates.

Have these services started?*

Select

Start Date of Services*

Agreement Term is the date the services shall commence.

End Date of Services*

Agreement Term is the date the services shall end on.

Requestor Name*

Point of Contact if there are questions related to this intake form. It is important this information is complete and accurate.

Requestor Title*

Requestor Email*

Work email address (sandi.net)

Requestor Phone*

Phone

Department ID*

Please use 4 digits.

School, Department, Location of Work*

This is the site on which the work will occur. If multiple locations, state "District-wide"

This is for where the school is located. Please provide complete address*

Agreement with (Company Name) Legal Name*

This is the legal name of the company or person performing or receiving the services. This must match the W9 tax form.

Company Point of Contact Name*

Person signing the contract

Company's Point of Contact Title*

Company's Billing Address*

Please include Address, City, State, and Zip.

Company Email*

Of the person signing the contract on behalf of the company

Company Phone*

Phone

Items Needed. Attach all applicable Items to expedite the contracting process*

W-9 Form

Drag and drop files here or

Resource*

Please enter the resource account that you will be using for this contract. This number requires 5 digits.

Budget String #- Year 1*

Must provide valid budget strings for all years - Email from budget analyst must be attached validating budget strings.

TBD is not acceptable

Please submit using this format:

xxxx-xxxxx-xx-xxxx-xxxx-xxxx-xxxxx-xxxx

Budget String Name (Resource Type)*

Name of Budget Analyst*

Budget Analyst Email*

Total Compensation or NTE Amount*

Important Notes to Contract Specialist:*

Authorized Approver*

Choose your Area Superintendent, Director, or Chief.

Select

Authorized Approver's Title, Email, and Phone No.*

This information is needed for the Board Agenda.

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