Common Funding Application Form

Common Funding Application for Student Programs/Events
To be used to request funding above/beyond regular budgetary allocations.

Program/Event Information
Event/Program Title:
Event/Program Date:
Date Form Submitted:
Student Club/ Organization:
PeopleSoft Department ID Number:
Student Contact Name:
UNIX:
Phone Number:
Event Location (Building & Room):
Please provide a description of the program/event.
1. List all of your projected costs:
performer/speaker:		food:
facilities:		travel:
lodging:		AV/ tech:
other:		hosts/servers:
Total Projected Costs:

2. List your organizational funds:
Your annual organizational budget: $
Current balance: $
How much are you using for this program? $
3. List your requests to be considered by specific funding sources
Campus Life Grants:$
College Council Co-Sponsorship: $
Dean’s Office: $
Currier NGB: $
Dodd NGB: $
Spencer NGB: $
Wood NGB: $
Chaplains Office: $
Community Engagement: $
Multicultural Center: $
Committee on Undergraduate Life (CUL): $
Zilkha Center: $
Dively Committee: $
College Council Nationals: $
Other: $
Please specify 'Other':
4. Follow the procedures and submit the completed application.
“I have read all applicable processes & policies for the individual funding sources from which I am requesting funds; I understand them and agree to abide by them. I have filled this form out completely and have submitted it on time. I will submit a completed Evaluation Form within 3 business days after the event, and I realize that by not doing so, any supplemental funding will be null and void.”
By selecting the Submit button you agree to the above statement:
Thank You!