Event Accommodations Fund Application Form

This form should only be used by academic units requesting funds to help defray costs of the provision of reasonable accommodations for event speakers and attendees.

Event Accommodations Fund

Faculty Contact Person

Name of Faculty Contact *

Email Address *

Phone Number *

Campus Box *

Campus Box of faculty contact.

Primary Hosting School/Department Information

School *

Department *

Type N/A if you do not belong to a specific department within your school or if your school does not have departments.

Business Manager Contact Person

This should be the name and contact information of the staff member responsible for accounting in your academic unit.

Name of Business Manager *

Co-sponsoring Departments/ Programs

List all co-sponsoring department(s)/programs(s)/speaker series/conference(s) or external partners. Type "none" if there are no co-sponsors. Note there can be only one application per event.

Email Address *

Phone Number *

Campus Box *

Event & Accommodation Information

Event Name *

Event Date(s) *

Event Location *

Accommodation Fund Justification *

State reason for request. What accommodation is being addressed?

Speaker Name(s) *

If your request for accommodation funding is speaker specific, please include speaker names. If not type N/A.

Event Website/URL *

Website/URL of event. Type "none" if there is not a website/URL.

Estimated Costs *

How much will the services you are seeking for your event cost? Funds are limited. This fund is set up to help defray accommodations expenses for speakers and attendees with disabilities, for academic unit-sponsored events.

Vendor Quote *

Maximum upload size: 16MB

Please upload documentation from vendor showing the cost estimate for services being sought for your event.

Dean/Chair Approval *

Maximum upload size: 16MB

Upload approval note or email from your dean or department chair. This need not be a formal letter. Documentation can include an email chain showing dean/chair approval.

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