A r c h i v e d  I n f o r m a t i o n

APPENDIX C

Recommended Application Forms

Schools and Libraries Universal Service Fund

Application for Eligible Services

FCC Form I

BLOCK 1: Applicant Information

1.	Name of Applicant
	___________________________________________________
2.	Applicant Control Number
	___________________________________________________
	___________________________________________________
	___________________________________________________

3.	Type of Applicant (check one)
	¤	State	¤	Library or library consortium
	¤	School district	¤	Consortium of schools, libraries and/or other entities
	¤	School	¤	Other (specify) ______________________
4.	Complete Mailing Address of Applicant

	___________________________________________________
	___________________________________________________

	City	State	Zip Code

	___________________________________________________

	Telephone Number	Fax Number	E-mail Address

5.	Contact Person's Name
	___________________________________________________
	Mailing Address (if different from above)
	___________________________________________________
	___________________________________________________

	City	State	Zip Code

	___________________________________________________

	Telephone Number	Fax Number	E-mail Address

6.	This form is (check one)
	¤	An original submission	¤	a revised submission (enter application control number for previous submission, if available; otherwise, enter the date)

Return to Appendix C. Recommended Application Forms			[ Form I, Block 2: Services Requested ]

This page last updated 8/10/97 (pjh).