EmailMe Form - Student Success & Equity Funding Request

Student Success & Equity Funding Request

MVC’s Student Success & Equity Committee requests are reviewed to ensure proposed projects support goals, objectives, and activities identified in MVC’s Student Equity, SSSP, and BSI Transformation plans. Funding requests are reviewed and recommended for approval or denial to the Vice President, Student Services by the assigned Student Success and Equity budget subcommittee/workgroup.

Funding requests will require two parts:

1. Funding Request

2. Project Completion Report

Name of Submitter *
Submitter Contact Information
If same as project/activity lead, leave blank.
Project/Activity Lead *

Name

Department/Discipline

Email Address

Phone Number
Project/Activity Participants *
Include names of additional project/activity participants
Project Information
Project Title *
Requested Funding Amount *
$ Dollars
Project/Activity Summary *
Provide an abstract or summary of your project/activity including targeted disproportionate impacts (as applicable).
Estimated Start Date *
MM / DD / YYYY
Estimated Completion Date *
MM / DD / YYYY
Funding
Funding Group *
SSSP
Student Equity
Basic Skills
Basic Skills Tranformation Grant
Funding Category *
Academic and Student Support Services
Orientation, Assessment, Counseling
Professional Development
Research Activities
Outreach
Follow-Up
If your request is not fully funded, have you identified other potential sources to request for this activity/project? *
No, I have not identified additional funding
Basic Skills Initiative
Basic Skills Transformation Grant
Department/Discipline
General Fund
Professional Development
Student Equity
Student Success and Support Program
Grant Project or other
If yes, check all that apply. Funding Source Information:
Student Success and Support Program | Basic Skills Transformation Grant | Faculty Development
Target Populations *
Asian
African American/Black
Hispanic/Latino
White
Two or More Races
Male
Female
Foster Youth
First Year Students
High School Students
Basic Skills
Low-Income Students
Students with Disabilities
Veterans
Check all that apply. See Appendix | Target Population Data
Indicator(s) addressed in this project or activity *
Access
Career and Technical Education
Career and Transfer
Course Completion
Degrees and Certificates
ESL and Basic Skills
Follow-Up
Orientation, Assessment, Counseling
Pre- and Post-Enrollment Activities
Research Coordination
Check all that apply. See Appendix for indicator descriptions
Implementation and Outcomes
Explain how this project or activity supports one or more of the Student Equity Goals and Outcomes. *
Describe your timeline to implement the project or activity. *
Identify your target group and estimate the number of students, faculty, or staff involved in your project or activity. *
Describe the expected outcome(s) for this project or activity. *
Identify the quantitative and qualitative data, along with process, you will use to access the effectiveness of the project or activity. How will you measure outcomes? *
Does this activity support Orientation, Assessment, Counseling, or Support for At-Risk Students? *
If yes, provide a brief description. If no, enter N/A.

Additional Information:
Matriculation | MVC SSSP Plan
Budget Details
2016-2017

Name
Department/Discipline
Email Address
Phone Number

Budget Allocations and Estimated Costs *

Professional Development for Faculty and Classified Staff
Non-Classified Employees
Tutors/Aides/Other
Supplemental Instruction
Consultant(s)
Guest Speakers
Equipment (for students)
Software
Supplies/Materials
Conference
Travel/Mileage
Travel/Meals
Travel/Hotel
Travel/Registration
Travel/Parking
Travel/Rental
Catering
Outreach/Marketing
Printing/Mailing
Other
Total (Please calculate; should be less than or match "Requested Funding Amount")

Enter "0" if category does not apply.

Budget Details
If "Other" was used, specify need.
NOTE: Please provide a details budget justification if project requests additional/new staff, equipment, hardware and/or software, and materials. Project or activity funds that are requested and approved must be expended on or before December 31, 2017.
Approval Information
Has this project already been approved by the Student Success & Equity Committee? *
Yes
No
If yes, who approved it?
If yes, when was it approved?
MM / DD / YYYY

Project Information

Funding

Implementation and Outcomes

Budget Details

Approval Information