Student Equity Funds Request Form
Coastline College has funds available to mitigate achievement gaps and address the needs of our diverse student body. Student Equity is the notion that all students deserve appropriate support to optimize the opportunities for learning and achievement. Use this form to request funds for a project or idea that supports the transformation of the College to develop clear pathways for success. Please also note that funds cannot be used for gifts, student stipends, political contributions, course delivery, professional learning, hiring, or supplanting funding that already exists.

Each request must be:

*Aligned with the College mission
*Aligned with Coastline Pathways
*Data-informed

Name of Requestor (first, last) *
Your answer
Email
Your answer
I am a *
Department or Program *
Your answer
Please choose a category for your request. Select as many as apply. *
Required
Please indicate which of the following disproportionately impacted student populations are to be served by the funding. Select as many as apply. *
Required
Briefly describe how your request aligns with the College mission. Visit http://www.coastline.edu/about/vision-mission to read the mission. *
Your answer
Briefly describe how your request aligns to Coastline Pathways. Please review the goals and mission of Pathways at http://www.coastline.edu/about/coastline-pathways *
Your answer
What is the dollar amount of your request? *
Your answer
Has this request been expressed in your Program or Department Review report? *
Please explain your answer above. *
Your answer
Does your request align to any other major College plan (e.g., Educational Master Plan, Wing Plan, etc.)? *
Again, please explain your response to the above. *
Your answer
Has there been funding for this activity in the past? If yes, please identify the funding source (e.g., a grant) and when it was funded. *
Your answer
Please briefly describe a timeline for how your funds would be used. *
Your answer
Should funds be provided, what kind of data will be collected? *
Please explain in detail what kind of data would be collected and how it will be used to evaluate the effectiveness of the funding. *
Your answer
Who will have roles of responsibility for this request? Include yourself and any others who will be involved. *
Your answer
Please describe a brief timeline that includes how funds would be used, how data will be collected, and a time to report to the College about the outcomes/results of the funding. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Coastline Community College. Report Abuse - Terms of Service