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CLAIM FORM 2023-24 Packard Stay & Play Grant #2022-74249 <br />Library: <br />I hereby request payment as a participant in the Packard Foundation funded Stay & <br />Play project. These funds will be used for expenses, incurred by June 30, 2024, <br />implementing my library jurisdiction's Stay & Play program(s). <br />Signature Title <br />Name Date <br />Payable to: <br />(If different than above) <br />Address: <br />******************************************************************************************************************************** <br />Approved by Paula MacKinnon <br />Signature Date <br />EMAIL one scanned, signed copy for review <br />to: christian@theyerconsulting.com <br />Then MAIL one original signature to: <br />Califa Group <br />Attn: Paula MacKinnon <br />330 Townsend St., Suite 133 <br />San Francisco, CA, 94107 <br />$