Request for Emergency Funds Form
Updated 10/16/19 Page 1 of 2
Requestor:
Date:
Total Amount:
Program:
Department:
Please describe the Emergency or Urgent Need. (Please limit response to 300 words)
Please describe how the lack of this item impacts instruction, student services, or on-campus
operations. (Please limit response to 300 words)
Please describe if there are other funding sources available to offset this cost. (Please limit response to 300
words)
Does this item directly impact the College’s accreditation?
YES NO
Does this item directly impact Health & Safety on Campus?
YES NO
INSTRUCTIONS:
This form should be used when requesting emergency funding AFTER the Resource Allocation Committee has allocated funds.
PROCESS:
1. Complete this form in its entirety.
2. Sign the form as the requestor.
3. Have the Division Dean sign and approve the form.
4. Have the Division Vice President sign and approve the form.
5. The signed form should be submitted to the Vice President of Administrative Services (VPAS) for review via email.
6. The VPAS will evaluate the need and present the request to the Resource Allocation Committee (RAC) via email.
Emergency Requests will require a 24 hour response
Urgent Requests will require a 48 hour response
7. The VPAS in cooperation with RAC will deliberate and IF FUNDING IS AVAILABLE will determine whether to allocate funds for the request.
8. The Requestor, Division Dean, & Division VP will be notified via email of the result.
9. Any approved allocations will be shared as information items at the RAC Committee & President’s Council
Request for Emergency Funds Form
Updated 10/16/19 Page 2 of 2
Was this request included in your program plan?
YES NO
Signature
Date
3. If Yes, What is the funding source?
4. Is this funding request approved?
YES NO
Did you submit the request to RAC during the allocation process?
YES NO
Approvals
Requestor
Printed Name
Signature
Date
Dean
Printed Name
Signature
Date
Vice President
Printed Name
Signature
Date
click to sign
signature
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