SJU FirstUp Funding Request

SJU FirstUp Scholars who would like to request funds for travel, extracurricular experiences, conferences, or other activities that could broaden the student experience, are asked to complete the following application. The SJU FirstUp Committee will review the application and notify the applicant of the decision. It is important that your application be neatly organized, thorough and thoughtful.

First Name

Middle Name

Last Name

Class Year

Banner ID Number

Campus Mail PO Box

Cell Phone

E-mail

I am seeking funding for the following activity/purpose:

Other (please explain)

Date: Departure/Start of activity or purpose

Date: Return/End of activity or purpose

Location of activity/purpose (City and State)

Travel $$ cost (personal auto--at $.545/mi., plane fare, taxi, parking, other. Please write N/A if not applicable OR if already included in activity)

Lodging $$ cost (Please write N/A if not applicable OR if already included in activity)

Meal $$ cost (Please write N/A if not applicable OR if already included in activity)

Registration or deposit fees (Please write N/A if not applicable)

If a deposit has been made, how much was it

Total Request (typically should not exceed $1000, but can if there is justification)

________________________________________________________________________
Please include a written response to the following question in a precise and organized manner. Paragraphs are recommended. No more than 500 words per question.

Why do you want to attend/participate in this activity?

________________________________________________________________________
Please read the following carefully and select the check box at the end to indicate your full agreement and understanding.

I understand that my attendance in this activity is supported by SJU. As such, I attend as a representative of SJU and my behavior and actions reflect upon the institution. I will not engage in illegal activity of any kind including the illegal use or consumption of alcohol or other drugs. I understand that I am responsible for providing receipts for all my expenditures and will be personally responsible for any personal expenses and will reimburse SJU as needed. I understand that I will be responsible for any expenses for which I do not provide a receipt. I understand there may be IRS tax reporting implications due for an award given to me. I understand that I am expected to participate fully in the conference events, activities, sessions, and meetings. I understand that it is my responsibility to talk with my professors about any classes I may miss and that I am responsible for all class material and assignments.

I agree to and understand the terms; and will write a reflection and/or preset if needed on how I used the funds and how the funds helped me.

I understand that as a First Year/Sophomore, I am allotted a total of $500.00 per academic year for programming. OR I understand that as a Junior/Senior, I am allotted a total of $1200.00 per academic year for programming.

Forms Manager

SJU FirstUp Funding Request

________________________________________________________________________ Please include a written response to the following question in a precise and organized manner. Paragraphs are recommended. No more than 500 words per question.

________________________________________________________________________ Please read the following carefully and select the check box at the end to indicate your full agreement and understanding.

________________________________________________________________________
Please include a written response to the following question in a precise and organized manner. Paragraphs are recommended. No more than 500 words per question.

________________________________________________________________________
Please read the following carefully and select the check box at the end to indicate your full agreement and understanding.