In-Kind Contribution
to the
Great Lakes Regional Pollution Prevention Roundtable

The Great Lakes Regional Pollution Prevention Roundtable (GLRPPR) is required by US EPA to obtain in-kind funding contributions from individuals who participate in activities related to the program. By completing the In-Kind Contribution Form every time that you invest your time in GLRPPR activities, you have the opportunity to help sustain the program.

What is "In-Kind Contribution"?

In-kind Contributions are an account of your time and expenses that you have contributed to GLRPPR. You do not necessarily have to contribute actual funds. However, if you do incur specific expenses, you can account for them on the In-Kind Contribution Form

How do I contribute?

Simply complete the form below and press "submit". Also, there is a PDF version of the In-Kind Contribution Form available that can be mailed or faxed to GLRPPR. Here are a few items that quailfy for in-kind contributions:

• Attending conferences,
• Participating in committee activities,
• Contributing resources and/or documents to the Resource Clearinghouse or Sector Hub, and
• Providing information to be shared among the region (i.e. articles for LINK, conference announcements, etc).

What expenses and activities count?

• Travel to and from GLRPPR meetings and conferences.
• Work hours NOT paid for out of federal grant funds.*
• Materials and supplies used for GLRPPR activities.

*Include preparation time in office, travel time, time spent working on GLRPPR related project activities, and time spent working at meetings (including conference calls) conferences and GLRPPR sponsored training.

In-Kind Contribution Form

Type of Contribution:	Board Project Steering Committee Summer Conference Winter Meeting Workgroup
First Name:
Last Name:
Organization:
Address:
City:
State:
Zip:
Phone:
E-Mail:

In-Kind Contribution of Labor Hours:
Use the following codes for In-Kind Contributions:
W - Time spent on this project at the office or at home
C - Time spent at a Rountable Conference or meeting spent on this project
T - Phone or conference call time
P - Other contributions

Date	Location	Labor (use codes)	Time (hrs)
		W C T P
		W C T P
		W C T P

Include time not paid for out of federal grant funds. Include preparation time in office, travel time, time spent working in meetings.

Other In-Kind Contributions:

Itemize portions of travel, materials, supplies and other expenses which count as in-kind contributions.

Travel:		Materials:
Supplies:		Other:

Your hourly wage: $