Temporary Application: Service Course Support Funds

A Web-based version of this application is under construction. Should you wish to complete an application before the Web-based form is available, please copy the form below, complete it, and email it to ServiceLearning@uscupstate.edu.


Service Course Support Funds Application

Thank you for your willingness to provide high-impact experiences for our students!

If you have not already explored the Service Course Support Funds Overview, please do so before you complete this application.

Requesting Instructor: ____________

SL/SE Designated Course: ____________

Date Expense will be Incurred: ____________

Enrollment (actual or estimated): ____________

BUDGET INSTRUCTIONS:
Clearly define all funds are required, even if the amount exceeds the allowable limit. Attach justifying documentation if available. Remember that documentation and receipts will be required to reconcile funds even if documentation is not currently available. If you've estimated your enrollment, please indicate how variation in enrollment will affect your budget.  A sample is provided and is followed by a blank form to be filled in. You may expand the budget table as needed.

 

SAMPLE BUDGET

Item

Cost Estimate 

Explanation/Breakdown of Cost Estimate                      

Paint

$200

10 gallons @ $20 each

Assorted Paint Brushes 

$20

20 sets from Mighty Dollar

Cleaning Supplies

$20

Soap, bowls, towels from Mighty Dollar

TOTAL  

$240

This estimate covers the expected enrollment of 15. 
If 20 or more students enroll, I will submit another 
request to cover the cost of additional supplies. If fewer
enroll, I may return some of the requested funds.

 

ACTUAL BUDGET

Item                              

Cost Estimate  

Explanation/Breakdown of Cost Estimate                      

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Proposed Use for the Funds
Clearly describe (a) how the funds will be used, (b) why these funds are necessary, (c) how these funds directly support the Service aspect of your course.

Other Funding Sources:
Please describe any other funding sources you have explored. Please include both plans for any expenses that exceed Service Support Funds awarded and plans for implementation of the service if funds are not awarded.  

Promoting Service:
How will you leverage your Service activity to help promote volunteerism, civic/community engagement, and/or service-learning on and/or off campus? 

Supporting Documentation:
Please attach any additional documentation you feel will support your application.