Student Government Association
1668 S. MLK Blvd Suite 104
Tallahassee FL 32307
Phone: (850) 599-3624
Fax: (850) 412-7913
Email: SGA@famu.edu

Special Allocation Request

*After Submitting your request please DO NOT Schedule an Appoinment. We will contact you to set up a time for your Special Allocation Interview*

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**

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:

Approximate number of students in your entity:

How many students does your entity serve?

How often does your entity meet?:

Location of meetings:

Dues amount for members of Organization, if applicable:

Campus Address:

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 Meeting:

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):

Balance of Outside Accounts (if applicable):

Name of financial institution with outside account(s):

Collected Money Totals for Current Academic Year

Membership Dues:

Fundraisers:

Private Contributions/Donations:

Federal Funding:

Alternate Sources:

Name of Contributor:

Amount:

List all previous SGA monetary allocations within the last 2 years

Year 1:

Term:

Amount:

Purpose:

Is your entity affiliated with any other funding sources?: Yes No

If yes, describe and please be specific:

If yes, how much (please be specific)?:

If no, why have you not looked into other funding sources?:

List and describe ANY and ALL fundraising events carried out by your entity for this fiscal year. Please provide the amount of funds raised. This should account for actual dollars raised and not projected goals.

Fundraiser Description:

Amount Raised:

Fundraising Total:

How much do you anticipate to fundraise during the next fiscal year? The anticipated fundraising for next year should be comparable or greater to the amount fundraised to this current year:

List and briefly describe ALL activities sponsored by your entity for this academic year.

Event 1:

Location:

Brief Description:

Line-Item Budget Request

What Items are you requesting from the Student Senate?

General Expense:

Activities & Programs

Travel:

Total General Expenses:

Total Activities & Programs

Total Travel:

Total Allocation Request:

Please attach a copy of all expenses paid for the current fiscal year. This should include every transaction made with the use of activities and service fees and any additional funding that your organization may have received.

Please attach any necessary documents required for verification ie invoices, budget documents, agendas and itineraries.

Upload File:

General Expense	Description	Quantity	Unit Price	Total Cost
Table Linen	White table linens to cover the tables for a banquet	50.00	15.00	750.00

Special Allocation Request

Organization Profile

Financial Background

Collected Money Totals for Current Academic Year

List all previous SGA monetary allocations within the last 2 years

Line-Item Budget Request

General Expenses

Activities and Programs

Travel Request