Fund Request Form

Organization Name (required)

Student Name (required)

Your Email (required)

Title of Program

Event Date

Event time (start-end)

Expected # of participants

Program Objectives/Description

Amount requesting

Fund is for? List anticipated resources

How much you currently have

Which initiative do you believe this program embodies

I understand that receipts in the amounting to the total amount received must be submitted no later than a week after the event. The account number for my organization is

And I understand that any funds I receive from SGA are to be used only for the items that I have listed in the budget that I have submitted within this request. Any additions or changes must be submitted to the Senate/ BOR and approved, otherwise I understand that the Senate/ BOR may not be responsible for the reimbursement of these funds. I also understand that if SGA grants my funding request, I must include SGA name as co-sponsor.”