Student Activity Fee Grant Form

First Name

Last Name

Email Address

Phone

Requested by (Organization making request or Student name)

Amount Requested

Date Needed

Contact Person's Name & Title (if applicable)

Request is for:

Phone Number of Contact Person

Target Audience (i.e. Students, Clubs, Community, etc.

Is this program open to all students?

If this is an equipment request, is the equipment available for all students to use?

If the answer to the question is no - who does have access to the program or equipment?

Describe the request in detail. The more detail, the better chance of a grant.

Costs. Give a detailed budget. The more detail, the better chance of a grant.

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