Funding Request Form

Funding Request Title*

Department*

Person Submitting Request*

Email Address*

Supervisor(s) with final authority*

Has the person(s) with final authority signed off on this request?*

Yes No

When do you need the Development Office Approval?*

This must be at LEAST two weeks from today's date

What are you requesting funding for?*

Existing Program New Program Special Event

Please provide a description of your request or program*

Name of Funder/Grant Opportunity

Website of Grant Opportunity

Grant Main Contact Information

Amount of Potential Grant

Deadline of Grant

:

Staff Member(s) Availability to Work on Grant*

Probability of Receiving Grant

25% 50% 75% 75%+

Grant Details

Eligibility Requirements? Special grant instructions? Anything else to share that would be beneficial in regards to the grant?

Please attach any additional files

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