(* Required)  
Date:   
Name: *

Campus Address: *

Phone Number: *

Email: *

Organization requesting funds (if applicable):

Event Title: *

Event Description: *
Rationale (explain the purpose of the event, how it meets the Commission’s criteria for funding--see webpage for more information--and the relationship to women/campus): *
Estimated Expenses (in detail): *
Identify Other Sources of Funding and Estimated Amount: *
Request (actual amount you are requesting from us with explanation if necessary): *
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Please note: The PCSW does not grant every request. We will deliberate your funding request at our business meeting and once a decision is reached you will be notified by the Chair of the PCSW. If you have been granted funds, the Chair will inform you of the amount via email. A form will also be attached to this email. Please print this form, fill it out completely and sign it. This is to ensure that the funds are properly distributed. The Chair will tell you where to send this form. Please send it via campus mail as soon as possible in order to transfer the funds in a timely manner. Thank you for your request.

Revised: January 12, 2010