Fillable Application Technology Fee Allocation (Eastern Wyoming College)

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Application Technology Fee Allocation (Eastern Wyoming College)

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APPLICATION FOR TECHNOLOGY FEE ALLOCATION
Submitter Name: ___________________________________________
Department: _______________________________________________
Campus/Site
(please circle site): Chugwater Douglas Glendo Glenrock Guernsey Hulett
Lusk Moorcroft Newcastle Sundance Torrington Upton Wheatland
Specific Location (i.e. room number, office, campus wide, etc): _____________________________________________________
Project Title: _______________________________________________________________________________________
Project Description: _________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Total Project Cost: $_______________ One-time Only Cost: $_______________ Ongoing cost: $________________
If ongoing money will be used, how will project be funded in the future? (i.e. continued use of technology fee, department budget,
etc.) ______________________________________________________________________________________________
Project Impact: _____________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Timeline for Project (Please be specific):_________________________________________________________________
__________________________________________________________________________________________________
This proposed project has been discussed and approved disapproved by the appropriate supervisor.
______________________________________________ ___________________________________________
Applicant’s Signature Date Supervisor’s Signature Date
FOR COMMITTEE USE ONLY
Submitted Date: ______________________
Review Date: _________________________
Approved Signature: _____________________________________________ Date: ___________________
Dee Ludwig, Vice President for Learning
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Application Technology Fee Allocation (Eastern Wyoming College)

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Completed 28 July 2020

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