ADSA Budget Request Form
Please fill out this form at least 10 days before you need ADSA funds. When you fill out the form, please also email anchoragedsa@gmail.com to let us know that a form has been submitted (just in case we miss it!). When the form has been received, you will receive a confirmation email from the Budget Committee. If you have questions, please feel free to email anchoragedsa@gmail.com.
Email address *
Name of Committee or Working Group *
Your answer
Your Name *
Your answer
Phone Number *
Your answer
Dollar amount you are requesting *
Your answer
Please explain what these funds will be used for. *
Your answer
Please provide a line item budget of the various expenses and their approximate dollar amounts. *
Your answer
If this event has to be canceled for reasons such as weather, do you have a back-up plan? NOTE: Should the event be canceled (and there is no alternative plan that costs money) funds must be returned to the ADSA Treasurer. *
What is your back-up plan, and does it have expenses associated with it? If so, please outline those expenses. Note: If the back-up plan costs less than the original plan, you must return the difference back to the ADSA Treasurer.
Your answer
When do you need these funds by? *
MM
/
DD
/
YYYY
What is your preferred method for receiving these funds? (Cash, cash app, or bank transfer). Or would you like the ADSA Treasurer to make the purchase or transaction? *
Your answer
Are you using any of your Working Group or Committee's restricted funds for this event in addition to the ADSA funds you are requesting? *
If so, please list the dollar amount you are using from your fund's restricted account?
Your answer
Are any members or non-members donating funds, space, or other materials for this event? If yes, please describe.
Your answer
Will these funds be used to support a fundraising event for Anchorage DSA? *
If so, please explain the fundraiser.
Your answer
Would you like to keep 20% of the funds you raise for your Committee or Working Group's restricted fund?
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