Student Stream Event Proposal Form

Student Stream Event Proposal Form Today’s Date: ___/____/____ Stream: ___________________________________________ RAs/ Other Staff Involved: ____________________________________________________ Submitter’s Name(s): __________________________________________________________ Phone #: __________________  Individual Proposal

E-mail: ___________________________

OR  Sponsored by a Committee/Organization:

_________________________________________________________________________ Program Title: _________________________________________________________________________ Brief Description: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ How does the program relate to your stream? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ What learning will take place through your program? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Will your program create community? If so, how? ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________

Date of Event: ________________________ Time: ________________________ Location: ___________________ How Many Students Can Participate? _________ Estimated Number of Participants:____________ Per Capita Program Cost:______________ Per Capita Travel Cost:________________

Total Program Cost:________________ + Total Travel Cost: _________________ = Total Cost:________________________

Explanation of Expenditures (Itemized cost per person/ per item): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Description of Publicity: ______________________________________________________________________________ ______________________________________________________________________________ Publicity Start Date (Please attach a sample of publicity): _____/_____/_____ By Signing Below I, ____________________________________________, state that if approved I will take on the planning and implementation of this program. ______________________________________________________________________ Student(s) Signature: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Approved  Y  N RA Signature:______________________________________ Stream Advisor Approval Date: _____/_____/_____ RA/FA comments: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________