San Francisco Unified School District
School Health Programs, SFCSD
1515 Quintara Street
REQUEST FOR FUNDING SOURCE FOR EXTENDED CALENDAR (EC),
K RESOLUTIONS, SUBSTITUTES, AND
STIPENDS FOR CLASSIFIED AND CERTIFICATED STAFF
*Note: All requests must follow this procedure.
TO BE FILLED OUT BY THE ORIGINATOR:
Requested by: Date:
Return to:
Please check appropriate category:
Request for K Resolution (For Consultants)
Request for Extended Calendar (Stipend for Certificated Staff)
Request for Extended Calendar (Stipend for Classified Staff)
Request for Extended Calendar (Extra hours / days for Certificated Staff)
Request for Substitutes
Date(s) of Service / Description / Funding / CostEstimated Total Cost: $
Program Supervisor Approval: ______
Director Approval: ______
After completing this section, please forward to Charlene Lee/Program Supervisor for approval.
TO BE FILLED OUT BY PROGRAM SUPERVISOR:
Funding Source:
Schl Safety Consolidated 01-07910-2014-xxxx-xxxx-152___
Schl Safety Consolidated 2 01-07911-2014-xxxx-xxxx-152___
NCLB Title IV Drug Free School 05-37150-2014-xxxx-xxxx-152___
Tobacco Use Prevention Education (CTALF) 05-66800-2014-xxxx-xxxx-152___
NCLB Alcohol Abuse Reduction 01-58165-2014-xxxx-xxxx-152___
TUPE Program, Gr 6-12, Cohort E 01-66900-2014-xxxx-xxxx-152___
Mayor’s DCYF Wellness Program 01-90550-2014-xxxx-xxxx-152___
PEEF:Prop H Other, Wellness 01-90553-2014-xxxx-xxxx-152___
SAMHSA Grant Project (Good Behavior Game) 01-58135-2014-xxxx-xxxx-152___
Elementary & Secondary School Counseling 01-58144-2014-xxxx-xxxx-152___
Mentoring For Success – Truancy Focus 01-58153-2014-xxxx-xxxx-152___
Mentoring – Gang Prevention 01-58157-2014-xxxx-xxxx-152___
Mentoring – Foster Youth 01-58158-2014-xxxx-xxxx-152___
Mentoring – Youth w Disabilities 01-58159-2014-xxxx-xxxx-152___
CDC Comprehensive School Health (YRBS) 01-58160-2014-xxxx-xxxx-152___
CDC Comprehensive School Health (HIV) 01-58160-2014-xxxx-xxxx-152___
CDC Comprehensive School Health (NPD) 01-58160-2014-xxxx-xxxx-152___
SNS: Fresh Fruit & Veg Program 01-53700-2014-xxxx-xxxx-152___
California Nutrition Network 01-58240-2014-xxxx-xxxx-152___
Child Health and Disability Prevention 01-78130-2014-xxxx-xxxx-152___
Foster Youth Services 05-73660-2014-xxxx-xxxx-152___
Foster Youth Services Juvenile Detention 05-73670-2014-xxxx-xxxx-152___
HAS Foster Youth Adoption 01-90215-2014-xxxx-xxxx-152___
Caltrans Safe Route to School 01-90205-2014-xxxx-xxxx-152___
Unrestricted Resources 01-00000-2014-xxxx-xxxx-152___
SHP Oral Health 01-00152-2014-xxxx-xxxx-152___
Unrestricted Resources – (LGBTQ allocation) 01-00000-2014-xxxx-xxxx-152___
DCYF Mayor’s Wellness Program FB 01-90539-2014-xxxx-xxxx-152___
Wellness Donations Account 01-93011-2014-xxxx-xxxx-152___
Trust Fund for Unobligated Expenses 01-93152-2014-xxxx-xxxx-152___
YMSM Initiative 01-90473-2014-xxxx-xxxx-152___
Metta Grant - Asthma 01-90711-2014-xxxx-xxxx-152___
PEEF:Prop H, Learning Support 01-90558-2014-xxxx-xxxx-154___ (Andi Hilinski)
Other Funding Source (please designate):
Approved
Not Approved Reason:
By
After completing this section, please forward to Charlene for SACS codes.
Return approved request to Originator to generate Extended Calendar Request, K Resolution/Contract, or Substitute Request Form.
Return unapproved request to Project Manager for re-evaluation.
Fund / Resource / Year / Goal / Function / Object / Org2014
2014
2014
2014
2014
8/18/2010