Funds Requested for event in which semester?
Fall ________________
Spring ________________
Summer ________________
Funding request is for?
Field Trip
Registratioin Fees (e.g. to attend a competition, professional industry related event, etc.)
Study Aboard
How will participation in the experiential event benefit the students' education?
Are all intended recipients registered HawaiiCC students in a declared
certificate or degree program?
Costs associated with attendance (e.g. tuition, books, fees, etc.) that are outside the normal cost
of the class.
Costs associated with experiential learning (e.g. finger printing charges, parking passes, etc.
required for internships)
Faculty Experiential Event Funding Request
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Please complete all areas, so we may reach you promptly.
Last Name:
First Name:
Email Address:
Phone Number:
Title (e.g. Faculty, Lecturer, Dean, etc.):
Department:
Course/Program associated with request:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
Please answer all questions below:
Does your request fit the funding guidelines?
View Guidelines
No
No
Please provide a detailed description of the request. What will the funds be used for?
______________ to ______________
Date or time frame of event?
Please upload a copy of the event flyer or web page.
How are you requesting funding be awarded/paid?
Printed Name
Date
Printed Name
Date
Printed Name
Date
Printed Name
Date
Printed Name Date
_______________
_______________
______________
How many students will participate?
How much funding is requested per
participant? (max request $250)
TOTAL OF FUNDING REQUEST?
Designee
Funded Date:
Notification Sent to Faculty Date:
Chancellor
Invoice from vendor (preferred) listing all student participants and the dollar amount of
designated request amount.
Reimbursement direct to student after providing receipts (non-taxable). May take 4-6 weeks for
processing.
Via Banner as an award to student (may be taxable) (e.g. tuition, books, fees, etc.).
APPROVALS: (only one required)
Division or Department Chair
Dean
Vice Chancellor for Learning
Upload Event Flyer
Upload participant list with UH ID#
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