MULTICULTURAL CENTER OF KUTZTOWN UNIVERSITY
THE MCC FUNDING REQUEST FORM
This form must be submitted no less than 3 full weeks prior to the date of the event or program.
BEFORE COMPLETING THIS FORM SEE THE BACK FOR GUILDELINES AND RESTRICTIONS
Student Organization or Department Name:
Lead Contact Person:
Phone Number:
Amount of Request: $
Request Date:
Email:
For University Departments, list the budget code for transferring funds, if approved:
EVENT TITLE:
DATE:
TIME:
LOCATION:
Briefly describe program or activity below:
Date:
ESTIMATED or ACTUAL EXPENSES
i.e. Travel
$
$
$
$
$
$
$
Actual or Estimated Total Costs
PROGRAM GOAL/AIM
$
(Feel free to attached a separate sheet if additional space is needed)
OTHER FUNDING
Amt#
Actual/Pending
OTHER FUNDING
Amt#
$
$
$
$
$
$
$
$
Actual/Pending
(FOR STUDENT ORGANIZATIONS ONLY) ADVISOR’S REVIEW AND CONSENT REQUIRED
By signing below, I certify that I have reviewed this document and I am in support of the organization’s solicitation of funds from the
Multicultural Center for this event, activity or project.
Advisor’s Full Name:
Phone Number:
Date:
Signature:
Email:
SHARE AS MUCH INFORMATION AS POSSIBLE ABOUT THE PROGRAM OR EVENT. WRITE OR TYPE OVER FADED DIRECTIONS.
RESOURCES
ACTIVITIES
OUTPUTS
OUTCOMES
LIST
THE INPUTS DEDICATED TO OR
CONSUMED BY THE PROGRAM
LIST
THE ACTIVITIES OR
PROGRAM COMPONENTS
IN PLACE TO ACHIEVE
DESIRED OUTCOMES
LIST
MEASUREABLE PRODUCTS
OF THE PROGRAMS’
ACTIVITIES
LIST
THE BENEFITIS TO
STUDENTS,
COMMUNITIES,
UNIVERSITY OR
ORGANIZATION
FOR MCC USE ONLY (ADMINISTRATIVE ACTION)
DIRECTOR’S SIGNATURE: ______________________________________________ DATE:_________________________________
□
APPROVED
AMT:$ ________________
□
DENIED (SEE BACK)
MULTICULTURAL CENTER OF KUTZTOWN UNIVERSITY
THE MCC FUNDING REQUEST FORM
This form must be submitted no less than 3 full weeks prior to the date of the event or program.
FUNDING GUIDELINES AND RESTRICTIONS:
•
THE MCC PREFERS NOT TO COVER FOOD/CATERING COSTS (EXCEPTIONS, IF ALL OTHER COSTS ARE COVERED BY OTHER
FUNDING SOURCES).
•
THE MCC CANNOT ISSUE PAYMENT TO A STUDENT ORGANIZATION ACCOUNT UNLESS AN INVOICE IS GENERATED FROM
KUSSI
•
RECEIPTS OR INVOICES TO BE PAYABLE TO A VENDOR, PERFORMER OR AGENCY FOR SERVICES OR SUPPLIES ARE THE
PREFERABLE TYPES OF FUNDED ITEMS
•
A RECEIPT AND/OR INVOICE MUST BE SUBMITTED PRIOR TO THE ALLOCATIONS OF ANY APPROVED FUNDS (EXCEPTION
DEPARTMENT TO DEPARTMENT FUNDING TRANSFERS)
•
THE MCC REQUIRES THAT ALL FUNDED PROGRAMS PRODUCE AND DISTRIBUTE SOME FORM OF EVALUATION TO THE
PARTICIPANTS OR RECIPIENTS AND SHARE THE RESULTS WITHIN 10 DAYS OF THE CONCLUSION OF THE EVENT OR
ACTIVITY. LIMITED EXCEPTIONS. FOR EXAMPLE: IN LIEU OF EVALUATIONS/SURVEYS FOR SOCIAL EVENTS, THE
PLANNERS MAY SUBMIT A NARRATIVE ASSESSMENT OF THE PROGRAM. IT MUST INCLUDE ESTIMATED NUMBER OF
PARTICIPANTS AND OVERALL OPINION OF THE OUTCOME/RESULT
•
THE MCC WILL ONLY APPROVE ONE FUNDING REQUEST PER ORGANIZATION OR DEPARTMENT PER SEMESTER.
•
THE MCC WILL NOT CONTRIBUTE MORE THAN 50% OF THE TOTAL ANTICIPATED OR ACTUAL PROGRAM/ACTIVITY COSTS
•
THE MCC WILL GIVE PREFERENCE TO PROGRAMS THAT ARE STUDENT DRIVEN AND ARE MOST DIRECTLY RELATED TO THE
MCC MISSION
•
SEE HIGHLIGTED ITEM BELOW. IF FUNDING IS APPROVED, AN ACKNOWLEDGEMENT IN THE PROMOTION OF THE
PROGRAM OR EVENT IS EXPECTED.
MCC MISSION: "DEVELOP POSITIVE, FORWARD-THINKING INDIVIDUALS FROM DIVERSE BACKGROUNDS BY ASSISTING THEM WITH
ATTAINING THEIR ACADEMIC GOALS AND BY PROMOTING MULTICULTURALISM; HELPING THEM TO BECOME RESPONSIBLE GLOBAL
CITIZENS."
MCC OBJECTIVES:
Leadership:
To develop positive, forward-thinking individuals and responsible citizens: by providing and facilitating opportunities for leadership experiences,
academic growth and community engagement.
Scholarship:
To assist students from diverse backgrounds with attaining their academic goals: by serving as a resource and an advocate to them and encouraging
academic excellence.
Collaboration:
To promote multiculturalism and assist with the advancement of the University’s vision, mission and diversity initiatives by collaborating with campus
and community organizations on multicultural and diversity projects to support a healthy, caring community.
Globalization:
To promote an understanding of cultural, ethnic and diverse elements of our region, nation and world: by fostering multicultural competencies of
our students and by demonstrating the interdependence among diverse peoples.
FEEL FREE TO USE THIS SPACE FOR ADDITIONAL COMMENTS OR ATTACH A SEPARATE SHEET:
*IF APPROVED: THE MAIN PROGRAM ORGANIZERS ARE REQUIRED TO ACKNOWLEDGE THE MCC CONTRIBUTION BY LISTING THE
MULTICULTURAL CENTER AS “A SPONSOR” OR INDICATED THAT THE PROGRAM IS “SPONSORED INPART” BY THE MULTICULTURAL
CENTER ON THE EVENT PROMOTIONAL MATERIALS. PLANNERS MAY USE THEIR OWN WORDING, HOWEVER, ACKNOWLEDGEMENT
OF FUNDING IT IS A CONDITION OF THE CONTRIBUTION.
IF THE REQUEST HAS BEEN DENIED, SEE THE REASON(S) BELOW:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
RB 07/2015