Basic Information
Your Name:
Date:
Name/Organization:
Address:
Phone(s):
E-mail:
Amount Requested:
By When:
Specific Questions
1. What purpose is the funding requested for?
2. Do you have a proposed text of a Motion for the SCNC Budget committee's agenda?	Yes No
*Describe the project/event in detail. Include as much supplemental information as possible (background information; supporting and opposing viewpoints, if available, etc.)
*Upload additional sheets as necessary.
3. What is the total budget for the project/event?
*Please attach itemized budget. (Attach additional sheets as necessary)
4. Are there another funding sources or matching funds?	Yes No
If Yes, describe:
5. What is the timeline for the project? (Be sure to include deadline for Board action, major dates, etc.)
6. How will this project/event be implemented, and by whom?
7. What would be the perceived/potential impact on the community, if we adopt the motion (pro and con)?
8. Are you aware of any potential conflicts of interest regarding the funding of this project for any Budget Committee and/or SCNC Board Member?	Yes No
If Yes, who: