Student Organization: * Please use the exact and formal name of your organization (e.g., no abbreviations). Purpose of the Organization: * Contact Information Contact's Name: * Contact's Title (if any) within the Organization, e.g., Treasurer, President: Contact's Local Address: * Contact's Phone: * Contact's UVA Email: * Event Title: * Event Type: * Social Cultural Education or Academic Service Other Event Type: Other Event Description: * Event Date: * Year Year20172018 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Generally, we only accept requests for events that have not yet occurred. Prior approval is required for retroactive requests. Event Time: * Hour Hour123456789101112 : Minute Minute00153045 am pm Event Location: * Event Rain Site (if applicable): Awards / Requests YTDRead-Only—These fields will pre-populate with your organization's award information year-to-date. This information includes requests received on or after Nov. 2, 2016. Information from requests prior to Nov. 2, 2016, are available upon request from mng9nf@virginia.edu. Total amount awarded to your Organization YTD: $ Number of Previous Requests YTD: Total Amount You Would Like to Request from VP&CSAO: * $ What is the target audience/who will participate? * How many attendees/participants are expected? * Is your organization a registered CIO? * Yes No Have you sought Student Council appropriations for this event? * Yes No If yes, why request additional funds? If not, please explain why. * Student Council appropriations is the primary fund source for student groups and student events on Grounds. We encourage all student groups to investigate whether Student Council appropriations would be a match for their event before submitting applications to VP&CSAO or other offices. Itemized Budget: * List all projected fund sources and expenses (including funds from other sources, e.g., Student Council, etc.). For details and sample budgets, see Budgeting: A Quick Guide. List of Co-Sponsorships: * Include organizations, if any, and how they will contribute to the event (financially or otherwise). Indicate if each is confirmed, if you have applied and are awaiting a decision, or if you intend to apply. Does this event involve food/meals, performance or service contracts, honoraria, travel, or gifts/awards? Certain restrictions and requirements apply to these and other expenses. See Special Considerations and Restrictions for details. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.