Funding Request Form 鈥� Service-Learning

Service-Learning Funding Request

Service-learning faculty who will need funds for a service-learning project may submit a funding request for a grant of up to $250. Requests are reviewed by the Service-Learning Advisory Committee on a rolling basis.

Faculty Member Requesting Funding
First Name*
Last Name*
Email*
Phone*
Campus Address*
Course Information
Semester and Year*
Course Title*
Department*
Course Number*
Number of Students Enrolled*
Amount Requested ($250 Maximum)*
Agreement to Service-Learning Seed Grant Criteria*
I acknowledge that I have read and will comply with the funding guidelines and award requirements for the administration of the Service-Learning Seed Grants. (Please type your initials to indicate agreement.)
Budget Information
Please provide the budgeted amount of funds AND description of how funds will be spent in each of the relevant categories below.
Supplies
Travel/Transportation
Food/Catering
Professional Services
Facilities Rental
Miscellaneous/Other
Funded Project Information
Community Partner Agency
Please describe how funds will be used to implement the service-learning project.*
Please describe how the service-learning project engages students in a meaningful service to the community.*
Please describe how the service-learning project supports the academic learning outcomes of the course, including how students will reflect on their experiences.*
Have you applied for other sources of funding for this project?*
If yes, please describe the other funding source and how much funding you have applied for.
Information Needed for Transfer of Funds
Office Administrator*
Email*
Phone*
Campus Address*
Department Index & Account Numbers for Transfer*

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Funding Request Form

Service-Learning Funding Request

Faculty Member Requesting Funding

Course Information

Budget Information

Funded Project Information

Information Needed for Transfer of Funds