Academic Affairs

Student Technology Funding Request Form

CONTACT PERSON PHONE Office Address Email DESCRIPTION OF REQUEST: Please provide a description of your request, including: 1) Benefit - How will SMSU students benefit from this project? 2) Promotion - How will you promote this project to SMSU students? 3) Assessment - How will the benefit be measured? How will student use be measured?
ITEM REQUESTED	ITEM COST	AMOUNT REQUESTED (enter numbers only)
1.	$	$
2.	$	$
3.	$	$
4.	$	$
	TOTALS:	$
ADDITIONAL SOURCES OF INCOME TO BE USED TO FUND PROPOSALS:

ADDITIONAL INFORMATION CONCERNING PROPOSAL HELPFUL TO THE STUDENT TECHNOLOGY FEE COMMITTEE: (Send an attachment of equipment advertisement or specifications, if possible, to Lorraine Weverka)

Student Tech Funding requests must have department chair or direct supervisor approval. Checking yes signifies you have received approval.