Date Submitted _________________
Graduate Student Organization
GRADUATE STUDENT FUNDING REQUEST PROPOSAL
____ Department Funding Request
____ Club Funding Request
NOTE:
A) THIS FORM MUST BE SUBMITTED AT LEAST TWO WEEKS PRIOR TO THE EVENT
B) GSO SPONSPRSHIP MUST BE ACKNOWLEDGED AT ALL EVENTS SUPPORTED BY GSO FUNDS
C) REIMBURSEMENT REQUESTS MUST BE ACCOMPANIED BY ORIGINAL ITEMIZED RECIEPTS
Name (of contact person): _____________________________________________________________
ID #: ______________________________
Email: _____________________________________
Address: ___________________________________________________________________________
Phone Number: _______________________________ Date of Event: __________________________
Club / Dept. Name: __________________________________________________________________
Title of Event: ______________________________________________________________________
Total # of participants expected: _______
Number of Steinhardt participants expected: __________
BUDGET BREAKDOWN:
Hospitality: (NOTE: GSO FUNDING WILL NOT COVER ANY ALCOHOLIC BEVERAGES)
a. Food & Drink _________________________________
$_______________
Performance/speaker fees (list by artist/speaker)
a. _____________________________________________
b. _____________________________________________
$_______________
$_______________
Promotional:
a. Advertising____________________________________
b. Publicity______________________________________
$_______________
$_______________
Miscellaneous (décor, space rental, supplies etc):
a. _____________________________________________
b. _____________________________________________
c. _____________________________________________
d. _____________________________________________
$_______________
$_______________
$_______________
$_______________
TOTAL PROPOSED EXPENSES
$_______________
Rev 4/1/11
Description of Program:
Please include information about the type of performance, expected audience size and make-up,
estimated start time, length of show, and any other pertinent information.
Purpose of Program:
Please include information on how this program will enhance the experience of Steinhardt students,
faculty, and staff and any other relevant information you would like the committee to have.
***********
Payee or Vendor Name _______________________________
Amount Requested $___________
Type of Expenditure (Check all that Apply):
___
Purchase Order (Attach contract, Order Form, Catalog Copy or Item Description)
___
Payee Reimbursement (Attach original receipts, and canceled check [if necessary])
___
Payment of Invoice(s) or Contract (Attach original or fax copy)
___
Reimburse University Account: Department __________________________________________
Account_________ Fund ____ Organization__________ Project__________ Program_______
***********
Questions about this Funding Proposal may be directed to [email protected]. Additionally, please
indicate if you would like GSO to advertise this event in our E-newsletter and our publicity chair will
contact you for more information:
____ Yes, please advertise our event
____ No, but thanks for your kind offer.
Steinhardt Graduate Student Organization
(For Internal Use)
**********************************************************************************
Date Received: ___________
Date Approved: ___________
Contact Notified: ____________
Reimbursed (Name of Student): _________________________________________________________
Amount Reimbursed: ________________
Date Reimbursed: _________________________