Supplemental Funding and Expense Preapproval Form

Form Instructions

The purpose of this form is to support school's and district's flexibility to make reimburseable expenses through the New Mexico Schools COVID-19 Testing Direct Funding Program.

Please use this form to:

Request funds above your school/district's initial allocation, either because all funds were spent in SY 21-22 or you expect to exceed your allocation in SY 22-23.
Request preapproval for expenses that you would like to make but need assurance that they would be reimbursed.

Responses to this form will be reviewed by an NMDOH/NMPED committee. You may be contacted if we have additional questions. If your request is approved, you will receive notice via email. We may take up to one month to approve your request. Requests will be approved based on:

The total amount of funds available in this grant
The appropriateness of the described expenses
The level of resources available regionally
The expediency that the school/district could expend the funds

Supplemental Funding and Expense Preapproval Form

Name of School District or School(Required)

Contact Name

First Last

Contact Email

Contact Phone

Is your school/district requesting additional funds?(Required)

Select "yes" if you would like approval to spend funds above your original allocation. This applies to schools and districts that a) spent all allocated funds b) did not return a signed award letter in SY 22-23 or c) anticipate expenses that would be reimburseable but exceed the amount of their allocation. Select "no" if you are requesting preapproval for an expense that does not exceed your existing allocation.

Yes

No

Did your school/district expend all funds allocated to you in SY 21-22?(Required)

Yes

No

How much additional funding is your school/district requesting?(Required)

Please describe in detail how you plan to use those additional funds.(Required)

For example, if you need additional funds to maintain your testing staff for the remainder of the school year, please describe how many staff members and their general job description. If you would like to implement a larger plan using these funds (i.e., upgrading technology to allow for better tracking and reporting of cases), please describe your general plan as well as what individual expenses they may entail. Please include an estimate of each expense incurred.

How would the expenses described above relate to COVID-19 prevention, mitigation, and response?(Required)

Please indicate if there are any budgetary processes that you will have to follow if approved for an additional allocation.(Required)

For example, please let us know if you would need to have these expenses approved by your Board beforehand. If possible, please let us know how long it would take after approval to expend.

Is your school/district requesting preapproval for expenses that would be made from the allocation in your original award letter?(Required)

Select "yes" if you would like to have preapproval to make an expense that uses your original award letter allocation (sent in July/August 2022). Select "no" if your school/district has no remaining allocation or is not seeking preapproval for expenses that can be made with your remaining allocation.

Yes

No

Please describe the expenses for which you are requesting preapproval.(Required)

For example, if you are requesting preapproval for reimbursement of staffing expenses, please describe how many staff members and their general job description.

What is the estimated total of those expenses?(Required)

How would the expenses described above relate to COVID-19 prevention, mitigation, and response?(Required)