Procedure No. 503.1 - Supplement 2

Revised: 09/06/16

Atlantic Cape Community College

SAMPLE REQUEST FOR INTERAGENCY AGREEMENT REVIEW FORM 

Form to be completed by Workforce Development in Consultation with Resource Development Department  

Date: Name of Funding Agency:  

Name of Reviewer:  

Name of Staffer to Lead Project:  

Amount of Agreement:  

Deadline for Submission:  

Targeted Population:

Level of Service:

Purpose of Agreement:  

Identify Potential Barriers: 

Additional Grant Information for Board Resolution:

 a.  Is there a match?        _____YES       _____NO    If yes, identify possible source(s)   

b. College In-kind contributions

c. Date agreement period starts:   

d.  Date agreement period ends:

 

Procedures:

Grant Procurement/Administration No. 503
Grant Procurement/Administration
No. 503.1
Grant Pre-Proposal Form, Supplement 1 No. 503.1s1
Acquisition, Use and Disposal of Perkins Equipment No. 503.2
Procedure for Letters of Support Related to Grant Applications No. 503.3

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