Request edit access
QEP Funding Request, 2016-2017

Improving cultural competency at Delta State will assist students in discovering and learning about other cultures; understanding cultural biases and differences; improving intercultural communication skills; developing empathetic skills; and moving effectively within a globalized society.

The QEP will delve into extracurricular activities through sponsoring, promoting, and creating culturally rich and instructive events on campus.

Michelle Johansen
DSU Box 3162 Jobe 221

Applications for speaker/event funding should meet the following guidelines:
1. Applications should be received by the QEP Coordinator four weeks prior to proposed event.
2. Requests may be partially funded or fully funded. If denied funding, applicants may appeal.
3. The event should offer students the opportunity to improve cultural competency at Delta State University.
1. All approved QEP events will include a DSU QEP logo on all promotional materials, and the QEP will be referenced in publicity.
2. Assessment results from the event will be shared with QEP Coordinator in a timely fashion.
Event Information
Contact Information *
Name, Department, Phone, and Email
Your answer
Name of Program, Date(s), Venue(s), and Brief Description *
Your answer
Number of Students Targeted *
Your answer
Number of Faculty Participating *
Your answer
Relevance to the Goals of Improving Cultural Competency at Delta State
Student Learning Outcomes *
All QEP-sponsored events will have identified student learning outcomes. Please mark all that apply. Students will be able to:
How will the program improve student learning outcomes? *
Your answer
How will you assess your speaker/event and measure the improvement of student learning outcomes? *
Please provide an evaluation plan or tool.
Your answer
Estimated Costs
Travel Costs *
Please provide estimated dollars and any relevant details (Ex: intention to share a room, carpool, ability to stay with family, etc.). Include lodging, transportation, air/mileage, and meals.
Your answer
Honorarium *
Proposed Amount
Your answer
Estimated Catering Costs *
Meals for attendees? Refreshments?
Your answer
Total Funding Requested *
Please include any relevant cost clarification/information for consideration
Your answer
Other Funding Sources *
Is this speaker/event receiving funding from other sources (university, non-profit, state, federal, etc.)?
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service