E-rate Year #: ____	Dates covered: July 1, (year) ________ to June 30, (year) _______
___	Technology Plan is in this folder covering years: _________ to _________

Check of  your progress:

___	Form 470 mailed (date): __________ Applicant's form identifier: ______________

___	470 Confirmation letter received (date): ______________________

___	Form 471 mailed (date): __________ Applicant's form identifier: ______________

___	471 Receipt Acknowledgement Letter received (date): ______________________

___	471 Confirmation letter received (date): ______________________

___	Form 486 mailed (date): __________ Reimbursement form number: ____________

___	486 Confirmation letter received (date): ______________________

___	Don't need to send Form 472s for (vendors):
			__________________________

			__________________________

			__________________________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Form 472 (vendor): _____________ Covering dates: ______ Mailed (date): ______
___	472 Confirmation letter received (date): ______________________
___	Received reimbursement check (date): ___________

___	Finished