CollegeoftheRedwoods
BasicSkillInitiativeRequestforFunds
ForCommitteeUseOnly:
Submitted:
DateApproved:
SummaryTitle:Click here to enter text.
FundingYear:Click here to enter text.
1.Author:Click here to enter text.
2.Date:Click here to enter text.
3.Email:Click here to enter text.
4.BrieflydescribehowyourproposalsupportstheBasicSkillsMissionStatementand/orthe
BasicSkillsannualplan:Click here to enter text.
5.IntendedOutcomes(shouldbespecific,measurabletargetstiedtothebasicskillsplan
and/orthebasicskillssectionsoftheCRannualplan):
IntendedOutcome(measureable)
RelationshiptoInstitutional
Plans
6.ActionandAssessmentPlanTimeline(specifyexactlywhatyouwillmeasure,whenand
howitwillbemeasured):
Action
How Assessing
WhenAssessing
7.Anticipatedexpenses(attachanotherpageifnecessary.Itemizedeachrequestand
includeallrelatedexpensessuchastaxes,shipping,benefitsestimatedat10%).Fromthe
dropdownbox,selecttheChancellor’sOfficecategorythatbestfitsyourneed:
Request(e.g.staff,
materials,tutor)
PurposeofRequest (e.g.tutoring,counseling,
suppliesforESLclasses)
Category
EstimatedCost
Choose an item.
Choose an item.
Choose an item. Choose an item. Choose an item. (choose
from
dropdown)
(includetaxes,benefits,
shipping)
1 CollegeoftheRedwoods
BasicSkillInitiativeRequestforFunds
ForCommitteeUseOnly:
Submitted:
DateApproved:
8.a.HaveyoupreviouslyreceivedBasicSkillsfundingforthisproject?☐Yes☐No
Ifyes,indicatewhattherequestwasfor,andabriefassessmentoftheresultsandwhyyou
needfurtherfunding.
Request
Results
Justificationforfurtherfunding
b.Willthisrequestrequireongoingfunding?☐Yes☐No
Ifyes,howlong*:Click here to enter text.Pleaseexplain:Click here to enter text.
c.*Projectsthatareintendedtocontinueforanindefinitetimeneedtobe
institutionalizedwithinthree(3)years.Defineyourplanforinstitutionalization:
Click here to enter text.
d.Areyoureceivingorapplyingforfundingfromothersources:☐Yes☐No
Ifyes,whatsource(s):Click here to enter text.
9.a.Listallfacultyand/orstaffinvolvedand/orwhoareresponsiblefortheproject.Click here to enter text.
b.Iftherequestisfortemporarystaffing,andyouknowtheperson’sname,pleaseinclude
ithere:Click here to enter text.
10.Wasthisrequest/willthisrequestbeincludedinyourmostrecentProgramReview?
☐Yes☐No
10a.Ifno,whynot?Click here to enter text.
11.Istechnologyinvolvedinyourproposal?☐Yes☐No
Ifyes,pleasedocumenttheresponsefromtechsupport.Clickheretoentertext.
(Requestsfornewtechnology,facilities,orequipmentrequireconsultationwithareaproviding
services;contactStevenRoperorAngelinaHillforassistance.)
12.Iunderstandthatifgranted,basicskillfundsaretobeexpendedinamannerthat
predominantlybenefitsbasicskillsstudents.Byacceptingfundingforthisproject,Iagreeto
provideawrittenororalreportdescribinghowwellintendedoutcomesweremet,theresults
oftheassessmentandhowthisinformationcanbeusedinthefuture.Projectsfundedfortwo
semesterswillrequireamid‐yearupdateaswellasareportuponcompletion.Pleasenote:
Thisisaone‐timeallotmentoffunds.Anyfuturefundingiscontingentuponthesubmissions
andgrantingofanewrequestandavailabilityoffunding.
________________________________________________________________________________________________________________
AuthorSignature
Date 2