Grant Request Form

Planning & Institutional Effectiveness

Grant Request Form

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Principal Grant Contact/Developer:
Principal Grant Contact/Developer Email Address:
Collaborating institutions/organizations:
Proposed Funding Agency:
Deadline Date:
Proposed Grant Title:

LSC Fiscal Commitment (cash, in-kind, etc.) necessary?
Will LSC be responsible for continuing the project when grant funding ends? Yes No

Briefly describe the commitment (including projected yearly cost).

Proposed Project Activities:
Intended Outcomes of Project:
List external project partners, including the role of the partner and any financial commitment/contribution to the project. List name of the contact person.
List other campus/program personnel who will be involved in this project.
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