Youth Programs Serving Non-Student Minors

Request for Approval ASU Sponsored or Third Party Camp Administered by an ASU employee

Name of Youth Program:*

What is the official Name of this Program?

Program Start Date:*

Program Finish Date:*

Is this Camp administered by or sponsored by Albany State University:*

Yes

Program Administrator name:*

Program Director name:*

Participants are Minors:*

Yes

Anticipated attendance Minors:*

How many Minors are you expecting at this event?

Participants Age Range*

Residential camp:*

Yes

Brief synopsis of purpose of camp and camp agenda/activities:*

Number of Program staff - Paid*

Number of Program staff - Volunteer*

By typing your full name below, I affirm that this program/camp is compliant with all policies and procedures for the protection of non-student minors.*

Funding Source*

If funding source is by a grant, grant administrator must approve expenditure of funds.

Select

Please Explain

Please read carefully - If you are an ASU sponsored program - Important Email addresses needed below

In the following Section, Please ensure that you are typing the correct email addresses for the appropriate people who will be approving your program. Failure to do so will result in a delay in processing your request. The administrator email and the Program Director Email is needed for notifications as approvals are submitted.

Program Administrator email for Approval notifications:*

Please include email address ONLY (Smartsheet will email this person if you enter the email correctly) Example: name@asurams.edu NOT: name@asurams.edu

Program Director email for Approval notifications:

*If this is the same person as above, please leave Blank. Please include email address ONLY (Smartsheet will email this person if you enter the email correctly) Example: name@asurams.edu NOT: name@asurams.edu

Grant Administrator email for Approval notifications:

Select

File Attachments

Please attach any Program flyers you may have.

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