Agnes Scott College Philanthropic Funding Support Request Form

This form is intended to be used by ASC faculty and staff who have specific ideas, programs, projects or activities that could be created, launched, enhanced or expanded through philanthropic support to achieve measurable impact that fulfills the college's mission. Please note: This request MUST have received prior VP approval before it is submitted. For questions or concerns, please email Henry Taylor (htaylor@agnesscott.edu) and copy Pilar Ramos (pramosnunez@agnesscott.edu).

Note: there will be a confirmation email sent to your VP following this submission.

Requestor Contact Information

Select or enter value
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Please enter the e-mail address(es)(only) of those who are managing this request. Separate the e-mail addresses by semi-colons (;).

Program/Project/Initiative Brief Description

Please attach (at the bottom of this form) relevant and supporting documents with more details, if necessary.

Please provide details on the outcomes you expect to achieve or meet after successfully securing the requested support funds. This can be a bulleted list or in a paragraph format.

Is this a new or existing program/project/initiative?*

(If donor-funded, please include specific fund names.)

If it is existing, will the funding requested replace or enhance current funding?*

(if applicable)

Have you requested and/or received funding for the program/project/initiative before?*
Are there other pending requests for your department?*

This should be a date.

Have you already identified potential funder(s)?*

(This refers to both individuals and organizations.)

Provide as much detail as possible

If unknown, write 'unknown'

Budget

This should be a dollar amount

This should be a dollar amount

Be as descriptive as possible, as this assists in the approval process. All supporting documents can be uploaded at the bottom of this form.

If you are requesting 100% funding, indicate that here.

Will the requested funding be budget relieving?*

Budget relieving can be defined as incoming funds that are applied toward the operating expenses of the college or to a particular project, thus “relieving” the college’s obligation of those expenditures.

Approval

Write in all that apply. If your supervisor, department head, and/or division VP are the same person, you only need to include the most highest-ranking member of your leadership chain. By including their information, you are confirming that they have approved the submission of this request.

@agnesscott.edu addresses only

@agnesscott.edu addresses only

@agnesscott.edu addresses only

Optional

Upload any relevant supporting documents (optional)

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(optional)

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