Alumni Association Grant Application for Student Organizations

Student organization name *

Name of student applicant *

Email address *

Phone number *

Amount of funding requested * $

Temple Dental faculty advisor *

Event or trip dates *

Number of participating students *

Number of people/patients helped (if applicable)

What is the mission of your student organization? (750 word limit) *

Total projected cost of the event or trip? *

Estimated cost per student (if applicable) *

Student organization details *

Yes, the student organization is a registered Temple organization.

Yes, the event/trip is approved by the associate dean of student affairs.

First time requesting grant

Previously awarded grant (also complete Section C)

Does your organization fundraise? *

No, our organization does not fundraise.

Yes, our organization fundraises.

How will your organization use the grant? (750 word limit) *

Please itemize the cost for each item or transaction. Note: Unused balance must be returned to the Alumni Association.

Additional information

Please include any information that you feel will help the grant committee make a decision. If you have received the grant in the past, please let us know why you should be considered for this year's grant.

Today's Date *

Month

Day

Year

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Kornberg School ofDentistry

Kornberg School of
Dentistry