Student Organization Additional Funding Request Form

Full Name of Student Organization*
Name of Student Applying*
Date of Request*
Email Address*
Type of Request*
Name of Event/Travel Information*
Date(s) of Event or Travel*
Educational Purpose*
Expected number of medical student participants*
Expected number of PA student participants*
Do you expect Faculty or Staff to participate in this specific event?
- Yes
- No
Number of Faculty expected*
Number of Staff expected*
Additional funds requested*
Detailed Budget Request*

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Office of Educational Affairs