American Speech-Language-Hearing Association

Information For:

ASHA Personnel Issues Grants

Budget Proposal Form

Please complete the funding proposal for your project for both expenses where ASHA funding will be used and expenses where state funds will be used. Please indicate not applicable with N/A.

* indicates required field.

 

Project Title:*

  

Human Resources
  ASHA Funds State Association Funds

Salary of Staff:*

Fringe Benefits:*

Contractual:*

Lobbyist:*

Other (please specify):*

Total Human Resources Expenses:*

Other Resources/Proposed Expenses
  ASHA Funds State Association Funds

Travel:*

Meals:*

Equipment:*

Supplies:*

Reproduction/Printing:*

Telephone:*

Postage/Shipping:*

Publicity:*

Other (please specify):*

Total Other Resources:*

Combined Total Expenses:*

President's Affirmation

The insertion of my name below is proof that I am the president of this association and can attest to the validity of the information contained in the Budget Proposal.

President's Name:*

  

State Association:*

  

E-mail:*

  

Today's Date (MM/DD/YYYY):*

  

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