If you will have supporting materials for this request (i.e. equipment bids, detailed travel budget information, maintenance agreements, publicity, etc) please make copies of these forms and place them in Rebecca Pennington's mailbox with this request form attached.

Funding Requested By

Email Address (you will receive notification of funding or denial as well as information on how to access funding at this email address)

Amount Requested

Request if for (travel, equipment, programming, etc)

Date needed

Contact Person

Title   Phone:

Target Audience (i.e. PSU Students, Club members, Community, etc)

If the request is for a program, is it open to all Penn State DuBois students? Yes     No

If no, who will benefit from the program?

If this is for a program, please include date, time and location of event.

If the request if for equipment, will it be used to benefit all Penn State DuBois students?              Yes     No

If no, who will benefit from the equipment?

Please give a brief explanation of why the funds are being requested. Follow the guidelines for the appropriate category as listed in the SAF Handbook. Include how the program/project will enhance out of class experiences and benefit the greatest number of students as outlined in the principles for the Annual Plan. Also, explain how this fits the needs of our campus, enhances student life, encourages involvement and builds community. In addition, please make sure you supply a breakdown of how the funds will be used.  For Ex: $50 for food, $25 for decorations, $75.00 for speaker. If you fail to supply an itemized list, your proposal will automatically be tabled.