All recognized student organizations and departments of Florida A&M University of whom have been active for one calendar year are eligible to apply for the allocation of A&S Fees, which are drawn from the students' tuition dollars. All applications are due at least eight weeks prior to the requested disbursement.

Please pay attention to each question and answer questions thoroughly.

Name of University organization or department (entity):

Leaders of the entity - fill out completely; if none, indicate by N/A

Your President and/or Advisor must be present for the Special Allocation Interview

Contact Information

Advisor

Name:

Email:

Phone:

President

Name:

Email:

Phone:

Vice-President

Name:

Email:

Phone:

Secretary

Name:

Email:

Phone:

Treasurer

Name:

Email:

Phone:

Person Submitting

Name:

Email:

Phone:

General Information

Approximate number of students in your entity:

How many students does your entity serve?

How often does your entity meet?:

Campus Address:

Organization Phone Number:

Organization Profile

What is the purpose of your organization/ department?:

What are your organization/ department's mission and goals for the current academic year?:

List the qualifications for membership into your organization:

Date & Time of Regular Meeting:

Date:

Time:

Location of meetings:

Dues amount for members of Organization, if applicable:

Dues Paid:

Total Financial Members:

Total Active Members

Financial Background

Present Balance with FAMU Comptroller (If Applicable):

FAMU Department account number (if applicable):

FAMU Fund Code (if applicable):

FAMU Program Code (if applicable):

FAMU Project Code (if applicable):

Outside Bank Account Information (IF APPLICABLE)

Name of financial institution with outside account(s):

Checking Account Balance (if applicable):

Savings Account Balance (if applicable):

STUDENT ORGANIZATION/DEPT:
Budget Awarded For Fiscal Year 2016-2017

TOTAL BUDGET REQUESTING:
For Fiscal Year 2017-2018

Goals For Fiscal Year 2017-2018

Goal 1

Goal 2

Goal 3

Goal 4

Goal 5

How do your organization/department mission align with FAMU FORWARD Strategic Plan, (WHICH PRIORITIES)?

Collected Money Totals for Current Academic Year

Membership Dues:

Fundraisers:

Private Contributions/Donations:

Federal Funding:

TOTAL ALLOCATION:

What date will you need funds for your 2017-2018 Annual A&S Budget Request?

Please upload a copy of your 2017-2018 Annual Budget Request:

You have successfully submitted your 2016-2017 Annual Budget Request

You will be contacted (24) within hours to (1) week prior to the next scheduled interview to confirm your 2016-2017 Annual Budget Request, Interview Date & Time.