Inclusion and Engagement Grant Application Form

Full Name

Applicant's E-mail Address (must use full Columbia e-mail address)

Student Group Name

Student Group's Email Address

I am applying for this ASGC grant as a(n):

ASGC-recognized student group

Departmental student group or entity

Independent entity

Event Name

Description of event (include type of event, intended audience, overall goal, etc.)

Start Date of event

End Date of event

Total amount requested from ASGC? ($2000 maximum)

Details of costs (supplies, speakers, food, etc.)

How many GSAS matching grants have you previously received?

How much outside funding have you received for this event?

Please list where the outside funding is from.

Full Name of Reference (group advisor, someone who supports your application for this grant and can certify this will promote diversity, equity, and inclusion)

E-mail Address of Reference

By signing my full name below, I affirm that all the information herein is true and correct. I have read the guidelines and requirements and understand that it is my responsibility to abide by them. I understand that an incomplete or incorrect application will be rejected. I understand that final reimbursement is conditional and subject to verification of expenses via original receipts, to international tax agreements, to ASGC paperwork deadlines, and to final approval. I also declare that if any of the above information changes between now and reimbursement, I will notify the ASGC Budget and Finance chair immediately.

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