Funding Request Form

Event Information

Name of organization/group:

Name of student submitting request:

Telephone number: E-mail address:

Event/program title:

Event/program dates: Start: End:

Brief Description:

Budget Information

Group's account number:

Event and budget details:


Speaker/performer name:

Speaker/performer costs: Publicity costs:

Meal/food costs: Facilities costs:

Travel costs: Lodging costs:

Other costs:

Total cost of event: Amount requested from the MCC:

Other funding you have requested:


      Organization/ department name

      Amount requested

      Request placed?

      Response/ comments



How much of your own organization's funds are being allocated towards this event?