Care Abounds in Communities Activity Planning Checklist
This checklist is designed to help you identify, organize, plan and implement your Care Abounds in Communities activity.
Please print out this checklist. You will find it extremely helpful.

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Activity Checklist
Care Abounds in Communities Request for Funding
At least thirty (30) days before an event, please submit a "Care Abounds in Communities Request Form" in order to request support funding from the Medina County Chapter to: Medina County Chapter Community Service Director, Shirley Hodek, 1050 Concord Dr., Medina, OH 44256-3007 email: sghodek@zoominternet.net. This allows the Board time to process a request.

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"Care Abounds in Communities Request Form" 20885F R4-09
for Medina County Chapter
Report for Funding Activity Results
Upon activity completion, receipts and a completed "Report for Funding Activity Results" must be submitted to the chapter leadership board.

For completed hands-on service activity; receipts (or copies of receipts) for all expenses need to be submitted along with the report. For fundraisers, send net funds raised along with the report. Although not required for fundraisers, it is a good practice to also include copies of expense receipts.

The form and receipts should be send to: Medina County Financial Director, Thomas R. Thiffault, 6981 W. Law Road, Valley City, OH 44280-9510.

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"Report for Funding Activity Results"
20885G R5-09
for Medina County Chapter

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Permission to Disclose Information for an Adult
If benefits are for an adult individual, a family, or a group of people, this person (or persons) has to sign a "Permission to Disclose Information" form. Click on the "Click to Open File" to get the Medina County Chapter form for adult recipients.
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