FLORIDA COMMUNITY COLLEGES

2004-2005 PRIVATE CONTRIBUTIONS FOR MATCHING PURPOSES

APPROPRIATION REQUEST – FINAL CERTIFICATION

 

 

COLLEGE NAME: ____________________________________________________________

 

 

Following are the amounts by program of private contributions requested to be matched by state

dollars. These contributions were received by February 1, 2004 and have not been matched from

previous state appropriations. Please include these amounts in the appropriation request for

2004-2005.

 

 

 

 

  

  

  

  

  

Private Contributions

State Matching

 

Received as of 2/1/04

Funds Requested

 

 

Scholarship Matching Program

  

$_____________ X 100.00% = $_____________

 

 

Other Eligible Uses

  

  

  

$_____________ X 66.67% = $_____________

 

  

 

The information provided above is accurate according to college records.

 

 

 

____________________________________________________________

 

  

  

  

  

President

  

  

  

  

Date

 

 

 

 

 

 

Complete and return this form by

5:00 p.m. on February 9, 2004

to: Maybelle Montford,

Community College Budget Office, 325 West Gaines Street, Suite 1201, Tallahassee, Florida

32399-0400.

J:\Finance\Work\Div-Forms\2004-05 Matching Program Certification Form.doc 12/29/03