Kansas Soybeans as a Food APPLICATION FORM
One semester and teacher per form
2020-2021 _____Fall Semester _____Spring Semester
School: ___________________________________________________
Address: ___________________________________________________
City: ________________________ State: _______ ZIP: __________
Teacher’s name: ______________________________________________
E-mail address: ______________________________________________
Telephone: _________________________________________________ Name of class: ____________________ No. of students:_____ Grade level: ____ Name of class: ____________________ No. of students:_____ Grade level: ____ Name of class: ____________________ No. of students:_____ Grade level: ____ Name of class: ____________________ No. of students:_____ Grade level: ____ Name of class: ____________________ No. of students:_____ Grade level: ____ Name of class: ____________________ No. of students:_____ Grade level: ____
Amount requested (can receive $2/student up to $400/semester): $ ________________
Teacher’s signature: ___________________________ Date: __________
Notes or special requests:
Please apply by September 30, 2020, for the fall and February 28, 2021, for the spring. We will be flexible with these deadlines due to COVID-19, but please apply before spending any funds. We have
a quick approval turnaround. Return to: Kansas Soybean Commission
1000 SW Red Oaks Place Topeka, KS 66615-1207
Fax – 785-271-1302 E-mail – [email protected]
FOR OFFICE USE ONLY
Amount approved: $ ______________________
FCS program coordinator:__________________________________ Date Received: ________
Approval Letter sent: ______________________ Entered in database: ____________
