Personal Information

Contact Person:

Organization:

Campus Mailing Address:

100 E. Normal Street, Kirksville, MO

Contact's Phone Number:

Contact's Email Address:

Organization Advisor Name:

Advisor Email:

Advisor Phone Number:

Program Information

Title of Program:

Type of Program:

(Concert, Workshop, Performer, Informational, etc.)

(Please check availability of rooms/space on the Student Union website)

Describe the program for which you are requesting a Diversity Enhancement Grant. 

     (Please be specific and include dates, times, locations, vendors, etc.)

Describe the impact that you would like this program to have on the attendees.

     (What will they take away from this program? How will this program celebrate diversity?)

Describe the demographic make-up of the ideal audience you wish to have and explain

how you plan on attracting such an audience. 

     (What constitutes a diverse audience? How and where do you plan on advertising this program?)

List other student/faculty/staff organizations or departments with which you will be

collaborating and explain why.

     (Please include whether you will be receiving funding from any of the groups identified and whether any

       will be helping with the planning or execution of the program.)

If awarded, describe how the grant funds will be allocated.

     (Please be specific.  Be sure to include estimates that were quoted by vendors and your own research.)

Signature:

Date: