Substance Free Programming Fund Mini-Grant Application

Organization Making the Request:
Individual Completing this Application:
WPI Address:
WPI Phone #:
E-mail:
Event Name:
Date of Event:
Time of Event:
Location of Event:
Amount of Request: (not to exceed $250.00)
What is the total anticipated cost?
Has this event been scheduled with the Events Coordinator's Office?	Yes No Don't Know
What other funds have you secured?
Please describe completely all related costs for the event (Remember to consider Plant Services and Campus Police costs):
Type in the following two words

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