Please print off a copy of this funding application for your use:
Name of Person Responsible for Proposal: __________________________
Address: ___________________________
Phone Number and E-mail : ___________________________________
Organization: _________________________________
Proposed Program/Initiative: _____________________________________
Date of Program/Initiative: __________________________________
Target Population: ______________________________________
Expected Attendance: ____________________________________
Briefly describe the program/intiative and what these funds would be used for: ____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Total Program/Initiative Cost: __________________
Total Amount of Funds Requested from CCQLE: ________________
Other Financial Support: ___________________________________
Please submit requests to:
Joslyn DiRamio, Graduate Assistant - VP for Student Affairs Office
41 So. Prospect St.
Phone: 656-2414 Fax: 656-8191
E-mail: jdiramio@zoo.uvm.edu
Last modified October 02 2000 01:37 PM