The University of Arizona

Student Affairs

Grants Available

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Section I - Faculty Sponsor Information

Your First Name*
 Your Last Name*
Department*
 Phone Number*
email*
 Faculty  Grad  TA  Staff
Send Approval Information to (Name, Department, Address)*:

Please Note: incomplete address/email address will result in delaying the approval process -- take the time to please give complete information.

Please add sponsor information below:

First Name
 Last Name
Department
 Phone Number
email
 Faculty Grad TA Staff

Section II - Proposal Information

Please describe the student/faculty interaction activity you are planning, include specific information on how it will encourage student/faculty interaction outside of the classroom:
Date of Activity
 Location of Activity

Is this an annual event or new event? Annual  New Event

Describe:

If transportation is needed, what arrangements have been made:

Est. Total # of Students Involved

Est. # Freshman/New Transfer Students Involved

Est. # Sophomore Students Involved

Est. # Junior Students Involved

Est. # Senior Students Involved

Est. # Graduate Students Involved

Est. # of Faculty Involved

Section III - Vendor Information

List all vendors to be used for this event (include complete address, zip code and phone number.)

Vendor One:

Vendor Two:

Section IV - Proposed Budget

Include tax, tip, and related expenses in your calculations. Applicants must contact all off-campus vendors to be sure they will accept a UA check or purchase order.
Vendor Item   # of Unit(s) Required   Unit (per
person) Cost		  

Total Cost by
Vendor/Item

Total Cost (ALL vendors/items included): Amount you are requesting:

Section V - Amount Requested

List any other funding sources for this activity:

Can this event take place with partial funding?
Yes  No   Maybe

If Maybe, please explain:

Section VI - Grant Information

If desired, check to which grant fund you are applying for:

Student/Faculty Interaction
Xerox
IKON/HP

(So that we may maximize the amount of funds awarded, the Central Office of Student Affairs reserves the right to approve funding from the most appropriate grant.)

Office use only, if you are done, select the submit button below.

Reference Number:
Date Application Submitted:
Date Application Reviewed:
DOS Required Date: 		Approval:
Amount Approved:
Date Confirm Sent:
Funding Period:

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