Student Involvement - VPLAC Match Grant Application Form

VPLAC Match Grant Application

Your IP address: '38.107.191.87' will be recorded when this form is submitted. Misuse of this WSU service may result in prosecution.

Please provide complete information. Supplementary & collateral materials can be sent to VPLAC Match Grant Program, CUB 320 C.

Be sure to put your name/project on the supplementary information so we can connect it with your online application. Make a copy for your records!

Deadline for Opportunity # 1: Wednesday, October 8, 2008.

VPLAC Match Grant Online Application

RSO	Academic Dept.	Office/Program

Primary Contact
(you?)

First Name	Last Name

Contact's Email

Contact's Phone

WSU Mailing Address

RSO Advisor Name

First Name	Last Name

RSO Advisor's Email

(Advisor will be contacted to confirm approval)

Dept/Org/Prgrm Name

Proposal Title

Event
Specifics

Date mm/dd/yr	Time	Location

Program
Description

Benefits to
WSU students?

Advertising
Plan

Support Mtrls.

Images	Video	Audio	Text	Resume	Other

(Forward support materials to VPLAC, CUB 320 C)

Expenses

Description

Amount

Total

Total Expenses

Non-VPLAC Income

Amount Requested from VPLAC ($500 or less)

Please type the letters below to submit the form:

Student Involvement and Leadership Development, CUB 320, PO Box 647204, Washington State University, Pullman WA 99164-7204, 509-335-9667, Contact Us