REQUEST FOR FUNDING - COOPERATIVE SPONSORSHIP COMMITTEE *

Please provide the following information to assist the Committee in evaluating your funding request.

Information on the NDSU Sponsor

Primary Sponsoring Department:
Form submitted by

NDSU phone

e-mail

Information on the Event

Name of Invited Speaker
Affiliation of Speaker
Dates of Visit Date of Event
Full Title of Seminar or Other Event

Information on the Cost of the Speaker's Visit

Estimated Expenditures for

Lodging . . . .$

Meals . . . . . $

Travel . . . . . $

Honorarium . $

TOTAL . . . . $

Amount requested from the Cooperative Sponsorship Committee:
$

Note: The Cooperative Sponsorship Committee will provide up to half of the cost of an event, with a maximum of $700 for an event with multiple sponsors and $400 for an event with a single sponsor. See the linked page for other funding guidelines.

Information on NDSU Funding Sources

Department Amount Initials
1.  
2.  
3.  
4.  
5.  

Note: Dept. #1 is the primary sponsor, others are co-sponsors.

*One copy of this document must be down-loaded, initialed by the Chair of each department,
and sent via campus mail to the Chair of the Cooperative Sponsorship Committee.