STUDENT ORGANIZATION FUNDS REQUEST FORM Please fill out the following form and return both an electronic and hard copy to an Executive Board Member for processing. All applications must be submitted by February 4th. Include accurate contact information as to ensure a speedy application process. ALL FUNDS ARE REIMBURSEMENT ONLY, but a payment may be made ahead of time if there is a special circumstance.* By filling out this application, you are agreeing that: The funds requested are used EXACTLY what they have been requested for Any unused funds will be returned to the Student Government All information provided is true to the best of your knowledge *Note: SGA will only provide funding for EVENTS that are held by the Student Organizations. Criteria to determine if the organization will receive the allocated funds: Due to limited funding, the amount of monetary allocation the Student Government will reimburse will be based off a certain criteria.* Some of the criteria considered are as follows: Whether the student organization in question is in good standing Whether the request has been made in a timely manner The total amount requested The total amount available to student organizations Whether the group receives funds from other sources Whether the group has received funding in the past and how effectively it was handled Past Events and Success of Past Events *Note: SGA will take each case individually. As such, SGA may make exceptions for special circumstances. 1 STUDENT ORGANIZATION FUNDS REQUEST FORM Funding Application Organization Information Organization Name: __________________________________ Organization Mission: In five to seven lines, explain what the mission of your organization is, and how it will benefit student life. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Organizational Account Number: _____________________________ 2 STUDENT ORGANIZATION FUNDS REQUEST FORM Contact Information Advisor’s Name:______________________ Advisor’s Number:_______________________ Advisor’s E-mail:__________________________ Primary Contact Treasurer: Secondary Contact Name: ________________________________________ ___________________________ Organization position: Preferred E-mail Address: ___________________________ _________________________ Preferred E-mail Address: Telephone number: _________________________ _______________________________ Telephone number: ______________ 3 STUDENT ORGANIZATION FUNDS REQUEST FORM EVENT DETAILS Event Title: ________________________________ Event Date and Time: __________________________ Event Location (Please include any other locations the organization might use): ______________________________________ Event Details: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Event Goals: In five to seven lines, explain how your even will benefit student life, and the goals your organization is hoping to achieve after its completion. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 4 STUDENT ORGANIZATION FUNDS REQUEST FORM __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Event Schedule (Please Attach): 5 STUDENT ORGANIZATION FUNDS REQUEST FORM Expense Information Co-Sponsorship/Other Funding Sources: Please list any other sources that are sponsoring your event and how much they are providing. Sponsor Name: __________________________ Contact: ______________________ Amount Donated: ______________$ Phone:______________________ Sponsor Name: __________________________ Contact: ______________________ Amount Donated: ______________$ Phone:______________________ Sponsor Name: __________________________ Contact: ______________________ Amount Donated: ______________$ Phone:______________________ Sponsor Name: __________________________ Contact: ______________________ Amount Donated: ______________$ Phone:______________________ 6 STUDENT ORGANIZATION FUNDS REQUEST FORM Budget Proposal (Please Attach): Please include a detailed proposal of your expected expenses. In this proposal, state which items your organization is purchasing, what they will be used for, and how much both the individual and total cost will be. 7