8/8/2019 Co-Sponsorship Application

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GUIDELINES FOR R EQUESTING FUNDING 

To be eligible for funding your student organization must 1) be officially registeredthrough the Student Activities Organization (SAO) and 2) have a valid and activemonetary account. All student organizations satisfying these criteria are fully welcometo apply for funding.

PSG is charged with allocating funding in a rigorous, neutral, and fair manner. Studentorganizations are thus asked to submit a detailed application to allow Purdue StudentGovernment to accurately evaluate the financial circumstances of your organization andthe qualifications of the request. Since funding is limited, PSG prefers to supportorganized groups with well-planned events.

Consideration for and amount of funding is often based upon the following criteria:Size of organization

Expected attendance 

 Venue 

Proposed Budget 

Requesting organization’s annual operating budget 

 All groups can apply for Purdue Student Government funding. Causes that PSG typically fund include the following categories:

Direct or indirect community service

Community organization or development

Education

 Well Being of the Students and/or Purdue University 

Purdue Student Government usually does not fund:Capital goods (products able to be reused following the event)

T-shirtsFood and Drink 

Student lodging, travel, or gas

Student salaries

Club/Intramural Sports fees

 Awards, gifts, gift certificates

To request an exemption to fund any of the above items, please refer to the ExemptionRequest page. If you request any of these items without an exemption, you will not beallowed to receive funding for said item.

 Amount funded is not to exceed fifty percent of total event budget, with a co-sponsorship limit not to exceed $1000, without senate approval.

 All Applications Must Be Turned in 2 weeks ahead of time Any Application Requiring Senate Approval Must Be Turned in 6 weeks prior to the event.

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Funding Application

Organization Name: ___________________________________________________

Group E-mail: _______________________________________________________

SAO Registered: YES NO BOSO Acct #_____________________

Primary Contact Name: ________________________ Title: ________________

E-mail: ______________________________________ Phone: ________________

Secondary Contact Name: ______________________ Title: ________________

E-mail: ______________________________________ Phone: ________________

Please circle any of the following which describe your group:

 A CADEMIC/PRE-PROFESSIONAL CULTURAL/ETHNIC  POLITICAL 

ENTERTAINMENT SERVICE R ELIGIOUS A THLETIC 

Describe the overall purpose of your organization and the types of activities it holds:

 ________________________________________________________________________________

 ________________________________________________________________________________

 ________________________________________________________________________________

 ________________________________________________________________________________

 ________________________________________________________________________________

Number of active students: ______

 Average attendance at meetings/events: _______

Is this group working with any departments or other organizations?

 ________________________________________________________________________________

 ________________________________________________________________________________

 ________________________________________________________________________________

Is this group affiliated with a national or parent organization?

 ________________________________________________________________________________

 ________________________________________________________________________________

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FINANCIAL INFORMATION  PLEASE FILL OUT ALL INFORMATION CLEARLY & CAREFULLY  

Section 1 - Account BalancesPlease list the balance of any accounts your group accesses. Include also the balances of any external,commercial bank accounts the group holds (e.g. Comerica, Chase Bank, etc.)

  Account Location Balance

$

$

$

Total Account Balance (sum of above columns) $

Section 2 – Funding Received And/Or RaisedPlease identify ANY other funding (besides dues) that your group has or will definitely be receiving/raisedover the semester. These sources could include outside donations, national organization allocations, etc.

Funding Source Expected Amount

$

$$

Total Expected Funding (sum of above columns) $

Section 3 – Funding Pending

Please estimate ANY other pending funding (besides dues) that your group could possibly receive over thesemester. These sources could include outside donations, national organization allocations, etc.

Funding Source Expected Amount

$

$

$

Total Pending Funding (sum of above columns) $

Section 4 – Dues

Expected Number of Dues-Paying Members (1)

Dues Charged Per Member (2) $ 

Total Dues Revenue {Field (1) x Field (2)} $

Cash Flow Summary 

Please copy the values from the above worksheet to create your cash flow summary.

Total Account Balances (section 1) $

Total Expected Funding (section 2) $

Total Dues Revenue (section 4) $

--MINUS--

Total Projected Expenses (page 6) $

Cash Flow $

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FINANCIAL SUMMARY  

Please attach any further information that may present a more complete financialpicture of your organization. This especially applies to club / recreational sports orgroups with exceptionally large budgets.

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E VENT DESCRIPTION NO. [____]Complete this page for each event. If you are holding a series of similar events, e.g., weeklyspeakers or meetings, list it as one event .

Event name: _________________________________________________________

Event date(s): ________________ Event location: ______________________

Briefly describe this event. What is its overall purpose? __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

Describe how this event will impact our campus and the student body.

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

If applicable, please describe how the program intends to benefit Purdue through community service, education, leadership development, and social action.

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

Describe how your events will include other groups or departments. __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

How many participants do you expect? ________

  Will you charge admission? YES NO If so, how much? ______________

 Who is eligible to participate? ______________________________________

  Are your date and location confirmed? YES NO

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BUDGET FOR E VENT NO. [____] Please fill out this form for each corresponding event description page. List ALL expenses.

Category:  Total Cost: Amount Requested:

 Advertising & Publicity 

(Posters, flyers, ect.)$___________ $___________

  _____________ $___________ $_________

  _____________ $___________ $_________

Rental

(Facilities, equipment, ect.)

  _ $___________ $___

  _____________ $___________ $_________

  _____________ $___________ $_________

Entertainment Fees

(Speaker, Entertainment, Band, ect.)

  _ $___________ $___

  _____________ $___________ $_________

  _____________ $___________ $_________

Services Provided

(Catering, Favors, ect.)

  _ $___________ $___

  _____________ $___________ $_________

  _____________ $___________ $_________

Other  _ $___________ $___

  _____________ $___________ $_________

  _____________ $___________ $_________

TOTAL EXPENSES $___________ $___________

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EXEMPTION R EQUEST 

 Include this page if you are applying for an exemption. 

Exemptions for the following goods

Capital goods (products able to be reused following the event)T-shirts

Student lodging, travel, or gas

Food and drink 

Student salaries

Club Sports fee charged by the Athletic Department

 Awards, gifts, gift certificates

Briefly explain the item(s) for which you are requesting an exemption for, why you need it, andhow your situation provides reason for BPC or CSC to grant you an exemption.

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

Off-Campus Travel

Briefly explain where you are going, and how it will benefit students.

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

 __________________________________________________________________

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Purdue Student Government Appropriations Form-School Year 2009-10

In consideration of their mutual promises and agreements:Contingent upon the allocation of funds in the Fall Term of 2009 by the Purdue StudentGovernment (PSG) of Purdue University, the Recipient agrees, bound by legal repercussions:

1.  To use the allocation exclusively for activities previously presented to and approved by PSG.No funding shall be provided for capital goods, t-shirts, newspaper ads, gas, Club Sports fees,

food or beverages, student airline travel, student lodging, awards, gifts, gift certificates, film, orfilm processing. Exceptions to these conditions must be pre-arranged, in writing with thePSG cabinet or Internal and Financial affairs chairman as appropriate.

2. Date Limitations

3. Recipient permits PSG to access records in Student Organization Accounting Services whichevidence Recipient's financial transactions - regarding the sum granted by SAO or PSG.

4. Recipient affirms that all statements made regarding its funding request are true and correct tothe best knowledge of the undersigned representatives.

6. If (1) any of the provisions of this agreement are violated by Recipient, (2) if any of the statementsof the allocation request are untrue, or (3) if any of the allocated funds are used in a manner on anactivity not previously approved by the contract, Recipient agrees to return, upon PSG's request,an amount equal to the full amount of the grant. This shall not be construed to limit the right of PSG to recover any additional sum that it is entitled to pursue through legal or administrativeprocesses.

7. Recipient agrees that failure to comply with the terms of this agreement - in any regard - may subject Recipient and/or its members to (1) full repayment of the grant, (2) civil liabilities, and(3) sanctions by PSG in accordance with its powers and operating procedures.

8. Statement of Guarantee:

 We, the undersigned parties, agree that (1) should Recipient become liable to the PSG forrepayment of any of the funds granted and (2) should the Recipient fail to repay the funds for

 which it is liable, we will personally pay to the PSG any unfulfilled debts on demand.

The below-signed representatives have read and understand this agreement; at least ONE signer must bean SOA Authorized Signer:

  ___________________________ _______________ ______________Name (Authorized Group official) Position Date

  ____________________________ _______________ ______________

Name (Group Member, different than above) Position Date

 _____________________________________________Group Name

 All Applications Must Be Turned in 2 weeks ahead of time Any Application requiring Senate Approval Must Be Turned in 6 weeks prior to the event.