Dr. Robert A. Chernak Opportunity Fund for Student Engagement Application
By completing and submitting the below-noted items you are acknowledging that the information is truthful and accurate; furthermore, you are giving permission for GW to use this information (including the required post-project reflection essay), in full or in part, to publicize the Chernak Opportunity Fund to future applicants, to steward current donors to the Fund, and/or to cultivate potential donors to the Fund - and to be available to support such activities as requested. Please allow up to three weeks for your application to be processed.
Name of Organization *
Name of Individual Completing Application
GW Email *
Cell phone: *
Project/program name: *
Date of Program/Project (if applicable)
MM
/
DD
/
YYYY
Location of Program/Project (if applicable)
Please provide a description and purpose of the program/project. *
(please limit all answers to 300 words per question)
How many students will be involved in implementing this program/project? *
If this program/project does not receive funding from the Chernak Fund, how will your organization proceed? *
Who is the program/project's audience? How many people are estimated to attend or participate? *
How will this program/project benefit the GW community? Are there other communities (outside of GW) served by this program/project? *
Next
Never submit passwords through Google Forms.
This form was created inside of The George Washington University.