Clinton Community College Fall 2019
Clinton Community College
Student Senate Special Event Funding Request Form
Name of organization
Contact making request Phone #
E-mail
1. Approximately how many students will attend this event?
2. What is the name of the speaker/performer/activity for which you are requesting funds?
________________________________________________________________________
3. What topic or type of performance will be presented? Please attach any relevant material
you have on the speaker/performer/activity.
4. What is the purpose of your event/program/activity?
5. When do you plan to have this event/program/activity?
6. In what venue will this activity take place?
7. Will you be seeking funding for this event/program/activity from any other sources?
Please list the other sources with their estimated contribution.
_______________________________ _______________________________
8. Have you received funding from the Student Senate for this event in the past? Please
provide details. __________________________
9. What funding will your organization contribute to this event/program/activity?
10. Does this event fulfill a cultural, social or academic need of our student community?
How?
11. Please explain how you plan to market this event.
___________________________________________________________________________
APPROVAL: DATE:
_______________________________ __________________
ADVISOR/IMMEDIATE SUPERVISOR/
DIVISION COORDINATOR OR VICE PRESIDENT
Please provide one of these forms for each event/program/activity for which you are requesting funds.
Clinton Community College Spring 2016
AMT REQUESTED SENATE
ALLOCATION
Senate Use Only
SUPPLIES
Event materials $ $
Give-a-ways $ $
Decorations $ $
Food items $ $
Paper supplies $ $
Other $ $
TOTAL $ $
PROMOTIONS
Flyers $ $
Posters $ $
Other $ $
TOTAL $ $
REFRESHMENTS
FSA Catering $ $
Other $ $
TOTAL $ $
TRAVEL
Transportation $ $
Lodging $ $
Meals $ $
Other $ $
TOTAL $ $
SPECIAL SERVICE CONTRACT
Speaker/performer contract fee $ $
Honorarium $ $
DJ services $ $
Security for event $ $
Film rental $ $
Equipment rental $ $
Other rentals $ $
TOTAL $ $
TOTAL REQUESTED FROM SENATE $ $
TOTAL APPROVED BY SENATE $_________________
Senate Representative to contact Organization: _______________________________