Student Senate (SSCC) Funding Request Application
Provide to: SSCC Financial Director Luis Flores by the first Wednesday of each month in
room 2311 by 5:00PM or by email to lflores@chabotcollege.edu with the required
signature. There will be no exceptions.
Important Notes:
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Applications received after the deadline will either be taken into consideration the
following month as written or returned to the applicant for resubmission for the
following month.
Please type (no handwritten proposals will be accepted).
If a question or section does not pertain to your request please write N/A.
*Any application not completed correctly or not completed in its entirety will not be
considered.
* Any Program, Event, or Project which has been previously funded by the Student
Senate which does NOT include a detailed budget of expenses will be rejected.
PART A- Contact Information
Event, Program or Project Coordinator and/or Contact (If Applicable):
Requestor (leave blank if same as above, if you are a student please indicate here):
Student applicants, if you are representing an entity on the Chabot College campus other
than yourself or group of collaborators, please name that entity here (Example: a student
club, college office or department):
Telephone Number:
Email Address:
Program, Event, or Project Name:
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Primary Sponsor:
Co-Sponsor(s):
Event Date:
Time:
Location:
Previously Funded by Student Senate?
(If yes, continue onto Part B)
Yes
No
(please circle one/ indicate)
PART B- Prior Award(s)
How much was awarded?
When was it awarded?
Please attach a detailed budget of how the funds were spent, a short evaluation of the
program, event, or project including the number of students served and in what way(s)
they were served.
PART C- Description
Program, Event, or Project Description:
Date of Event or Project Launch Date:
Program, Event, or Project Goals or Purpose:
Number of Students the Program, Event, or Project would serve:
What benefit(s) can students expect to receive from this- or will receive?
Is the Program, Event, or Project intended for a particular sector of students (Example:
students in special programs):
Other information:
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Part D- Financial Information
Please complete the following and attach a detailed explanation of all anticipated
expenses and revenue as well as other funding sources.
Total Estimated Expenses: $
Total Other Funding Sources: $
Total Student Senate Funding Requested $
If approved, how should the funding be received?
If a Co-Curricular account is to be used, please state the following:
Account Name:
Account Number:
*Other funding sources may include college or general funding, co-sponsorships,
scholarships, grants, etc. Please include all details of revenue sources, such as
advertising, ticket or concession sales.
Attachments to include with application:
1. Detailed proposed budget.
Include production, travel, registration, and all other costs specific to the Program, Event
or Project.
2. Any related marketing materials.
3. If applicable, samples of previous or similar Events, Programs, or Projects.
4. Any supporting documents for the proposal: Mission; history of the Program, Event or
Project; Program, Event, or Project successes – anything that will help the Budget
Committee understand your proposal.
CERTIFICATION I certify that the information provided in this proposal is true and
correct to the best of my knowledge:
Signature: ________________________________
Name (please print):________________________
Date of Submission:
FOR BUDGET COMMITTEE USE ONLY
Application Received On: ______________
Outcome of Review:
Recommended
Not Recommended
Date:
Notes:
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