Cross-Cultural Community Service Fund Application
The Cross-Cultural Community Service (CCCS) Fund is endowed by a Middlebury College
Class of 1987 alumnus and supports international service-learning and community-building
internships and/or related volunteer service opportunities for undergraduate students. These
internships and service initiatives may be student designed; preference is given to those
opportunities in a culture distinctly different from the applicant’s background. Funds are
available throughout the academic year and for summer experiences.
CCCS grants can cover travel and other expenses associated with an internship or service
abroad. In addition, grants can be used to attend conferences or events (e.g., travel, registration
fees, etc.) with an international theme in the U.S. While there is no maximum amount for which
to apply, typical grants range from $250-$750; funds are limited and are intended to support as
many student initiatives as possible. Therefore, it is important that you seek additional funding
from other sources as appropriate; please note other sources requested, accordingly, including
your own expected contributions (see Excel budget worksheet). If a group of students wishes to
apply for a grant from this fund, all student names may be included on one application. These
grants promote international civic engagement initiatives not otherwise fully funded by a
department or student organization budget.
Please complete the grant application below and worksheet at least 14 days prior to when
funding is needed to support your project. Applications are typically reviewed on a weekly
basis. If your request for funding is granted, you will receive a form that will instruct you
regarding procedure for reimbursement and written evaluation. Please direct questions and/or
submit the completed application to Community Engagement director, Tiffany Sargent, at
tiffanys@middlebury.edu or stop by the 118 South Main St. office.
J Term Internships! If you are seeking funding to support a for credit J Term internship,
awards are typically $500 per student. (Apply for funding through Community Engagement,
even if you are pursuing academic credit during J Term.) Pursue the credit option through CCI,
the Center for Careers and Internships (link is to the CCI Winter Term Internship site).
I.
APPLICANT INFORMATION:
Full Name:
Class Year:
Commons:
Email:
Country of
Citizenship:
Application Date:
Cell Phone:
Major (if declared):
ID Number:
Financial Aid Recipient? ___Yes ___No
Box #:
II.
ACTIVITY / PROJECT INFORMATION:
Desired Project /Activity:
Proposed Date(s):
Location:
If for J Term Internship: Is this J Term proposal for credit? ___ Yes __No
Apply for funding through Community Engagement, regardless
If you checked “for credit:” of whether or not you are also seeking J Term credit. (New!)
Transportation Method: If applicable
Housing (hotel, etc.): If applicable
Any Class Conflict(s)? “X” One __ No __Yes If yes, submit Absence Approval Form(s)1
III. SHORT ANSWERS:
1. Description: Add below a clearly worded and detailed description (one-page) of the
activity or project and its greater significance to: (a) any activities in which you
participate or have participated, and/or (b) your academic studies.
2. Community: Describe how do you plan to relate the knowledge or experience that
you acquire through the program to our Middlebury community and/or with the
greater local or global community in the future? Please note any specific programming
or other ideas that you envision.
3. Budget: Complete and return the separate “CCCS Grant Itemized Budget” Excel
worksheet. See “Sample CCCS Grant Budget” for help.
Updated 11.03.14/TNS
1
Signed Absence Approval Form(s) must be submitted with this application if your proposed activity will result in
absence from a scheduled class or other mandatory academic commitment.