Student Government Association Application for Funding

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Student Government Association Application for Funding 2016-2017 Read all instructions/guidelines before completing your request. Completed forms may be submitted to UC414 at least three weeks prior to your event. Be aware that SGA funding is meant to supplement existing funding and not be the primary source of funding for any event. Fund: Please mark which fund you are applying for: Discretionary Fund Student Organizations Fund Organization Basics: Organization name: Student Membership: Total Membership: Description/Purpose of Organization: Does your organization have a website? If yes, provide the link. Event Information: What is the name of your event/program? Date of event: Location of event: Describe the purpose, goals and objectives or the event:

What fundraising or what other sources of funding has your organization acquired? Please include specific amounts raised/received. What do you expect this event to bring to Southeast s campus and community? What type of advertising will be done for this event? (Please attach copies if applicable) Additional Information: Please attach the additional information needed for the account applying for: For Discretionary Applications: Itemized Budget (Be as specific as possible. Each item must be listed along with price.) Discretionary Funding Agreement (Attached) Travel Itineraries and Conference Information (if applicable) For Student Organization Applications: Itemized Budget (Be as specific as possible. Each item must be listed along with price.) Advertising Example

Contact Information: President s name: S0# Phone number: Email address: Treasurer s name: S0# Phone number: Email address: Individual Preparing the Budget: S0# Phone number: Email address: Faculty Advisor: Phone number: Email address: Signatures: I,, acting as an authorized representative for my organization, understand that my organization must comply with the Student Government Constitution, By-laws and Policies for all funds received through Student Government. I hereby attest that the rules/policies have been read and understood. I have presented all information truthfully and completely to the best of the organization s ability. Student Organization Organization President Organization Advisor Organization Treasurer

***The Discretionary Agreement is only required for those applying out of the Discretionary Account*** STUDENT GOVERNMENT DISCRETIONARY FUNDING AGREEMENT OVERVIEW Entities receiving discretionary funding will be required to sign and complete the terms of the Discretionary Funding Agreement document. Failure to sign and/or complete the terms stated in the agreement may result in one or more of the following, as determined by the Executive Committee: a. Loss of opportunity for funding from the Discretionary account for the remainder of the academic year and/or the following year. b. Loss of opportunity from the Student Organizations account for the remainder of the academic year and/or the following year. c. Request for repayment in part or in full of currently allocated funds.

***The Discretionary Agreement is only required for those applying out of the Discretionary Account*** STUDENT GOVERNMENT DISCRETIONARY FUNDING AGREEMENT After receiving funding from the Student Government Discretionary Account, agrees to the following: I. To attend any and all conference meetings/sessions; II. To spend Student Government money only for the purposes allocated; III. To meet with Campus Life Business Analyst and submit necessary paperwork within one month after the conference/event/competition or within a time period as determined by the Campus Life Business Analyst; IV. To submit a one-page document within one month after the conference/event/competition detailing involvement and resulting benefit to Southeast students. understands and agrees to the terms listed above. We understand that failure to abide by these terms may result in one or more of the following, as determined by the Executive Committee: a. Loss of opportunity for funding from the Discretionary account for the remainder of the academic year and/or the following year; b. Loss of opportunity from the Student Organizations account for the remainder of the academic year and/or the following year; c. Repayment to Student Government in part, or in full, of currently allocated funds. Signed: ORGANIZATION PRESIDENT OR REPRESENTATIVE ORGANIZATION ADVISOR STUDENT GOVERNMENT ADMINISTRATIVE ASSISTANT