Project Title Request is for: (a new facility, modifications, etc...) Contact Person Name Contact Person E-mail Contact Personal Phone Requesting Organization/Department Rationale Brief Explanation of why funds are being requested. Follow guidelines for request. Explain briefly what improvements, expansions, or recreational/multi-use facilities are being proposed. Please include how this request fits the needs of the students in a non-academic fashion. Request Criteria Estimated Total Amount of Expenditure Estimated Facilities Fee Funding Additional Funding #1 Additional Funding #1 Name Additional Funding Contact Name Additional Funding Contact Phone Additional Funding Contact E-mail Additional Funding Budget Number Description 1. Please provide a detailed description of improvements, expansions, or recreational/multi-use facilities requesting funds. Discuss how the infrastructure of the campus is fit for this project, where this project(s) will take place, etc. Student Benefits Explain how this will encourage student involvement and how it will benefit the majority of the student body. Project Correlation Does this project correlate with any goals or strategies incorporated in the campus strategic planning handbook? If so, list where so the committee can further review. If not, leave blank. Thank you The Penn State New Kensington Facilities Fee Committee thanks you for your request and proposal. You will be notified of the status of your request after review and voting by the committee. Office Use Only Office Use Only Date Received: _______________ Date Reviewed by Committee:_______________ SGA President:______________________________ Approved: Yes or No (Circle One) Date Approved:_______________ Reason, if denied:______________________________________________________________________________________________________________________________________________________ Official Signatures Chancellor: ______________________________Date:_______________ Reason, if denied:______________________________________________________________________________________________________________________________________________________ Total Amount Granted: $_______________ Date forwarded to University Park, if $10,000 or more:_______________ Date Final Approval Received: _______________ Reason, if denied:______________________________________________________________________________________________________________________________________________________ CAPTCHA Submit