UCSC Funding Request Form

Is your course comprised of at least 50% UCOL students as required by the guidelines?

Yes

First and Last Name:

Email:

Phone Number:

Title of event/program:

How many people are you expecting to engage with these funds?

Date of event/program:

Start time of event/program:

Location of event/program:

Class Section Number, if applicable:

Please provide a brief description of the event/program:

Total amount you are requesting from UCSC?