Roosevelt University

Student Activity Fee Allocation Committee (SAFAC)
Program Funding Request Form

Term
Organization
Contact Person
Title
Phone
Email
Program Title
Program Description:
Program Location
Program Date and Time
Anticipated Attendance
If co-sponsored program, please list co-sponsoring group(s):
Program Budget	Amount Requested
Promotional Materials (mailings, posters, banners, flyers, etc.)	$
Security (necessary if the event takes place after building is closed)	$
Facility Rental	$
Refreshments (see student catering guide)	$
Entertainment/Speaker Fees	$
Decorations	$
Miscellaneous (provide description)	$