Student Senate Funding Request Form

Requester Information

Requester Name

Organization Information

Date

YYYY

Organization Name

Number of Active Members

Is the organization chartered?

Yes

Faculty Advisor

Faculty Advisor Phone

Officer #1

Name

Position

Phone

Officer #2

Name

Position

Phone

Officer #3

Name

Position

Phone

Officer #4

Name

Position

Phone

Officer #5

Name

Position

Phone

Funding Request

Total Amount of Funds Requested

USD

Reason for Request

Is your funding request related to an event?

Yes

Event Information (If Applicable)

Date(s) of Event

Nature and Purpose of Event

Other Means/Sources Your Club has Used to Fund this Event

Additional Information

Please note that your club will be evaluated based upon community involvement, university involvement, your willingness to put forth your own money to fund this event, presentation, and fund raising attempts, the overall purpose of the event, and the value of what this event will bring back to the university.

Please include a line item breakdown of all expenses that you would like Student Senate to fund

Please provide additional information about the event for which you are requesting funding

Please provide additional information about your club that you would like us to take into consideration

I agree that I have completed all questions with accurate and complete answers.