Student Services Fee
Funding Request for FY18
Name of SSF line:
Name of SSF line administrator:
Name of person completing this funding request:
Briefly respond to each statement below providing enough detail to ensure the Student Services Fee Committee
(SSFC) will have the information to accurately review your request. Insert your responses below each question
or statement. Your submission should be limited to a maximum of three pages (including this page) with no
answer exceeding 200 words. It should be double spaced, using size 12 Times New Roman font.
Send the following information to Katie Evans at evanskah@uni.edu by January 19, 2016:
 Completed Funding Request Form. [Save using the format of “Line Name Funding Request for FY18”
(example: Panther Pass-Music Funding Request for FY18).]
 Excel spreadsheet entitled “Revenue and Expense Report.” [Save using the format of “Line Name
Revenue and Expense Report” (example Panther Pass-Music Revenue and Expense Report).]
 If more than a 5% increase in funding is requested, provide a detailed budget for the additional amount
and justify the need. [Save using the format of “Line Name Budget Justification (example: Panther PassMusic Budget Justification).]
FY16 Allocation
FY17 Recommended
Allocation
FY18 Request
1. Provide a brief explanation for any increase requested.
2. How many total UNI students participate in your program, activity or service? If possible, also
please give unique student numbers. Showing multiyear trends in participation is preferred.
Indicate how the numbers were calculated.
3. Have external or internal factors impacted student participation or affected your overall
budget? If so, please explain.
4. Describe your efforts to seek alternative funding and/or to find ways to collaborate with other
entities to improve efficiency and reduce the need for student fees to support your operation.
5. What will happen to your program, service or activity if you don’t receive the total dollars
requested? Indicate how you will prioritize your budget request if full funding is not received.