Project Proposal Form

HKUST Service Learning Day 2018 Project Proposal Form

Notes to Applicants: 1. Completed proposal form should be submitted to HKUST Connect office at Room 1001 (Lift 4) by 9 February 201 8 . 2. The proposed project should be held in April 2018. For multiple-time service project, at least one service activity should fall on the period. 3. Proposal will be assessed based on project feasibility, level of student involvement and contribution to the community. 4. All applicants must register with HKUST Connect. Applicants may register with HKUST Connect together with this application. Registration forms can be obtained through http://connect.ust.hk/stud_in_action/volunteering.html or outside HKUST Connect office

Part I Contact Information Name in Chinese Name in English: (if applicable): Surname First name

Student ID: Mobile Tel No.: ITSC Email:

Did you register with HKUST Connect before?* No** / Yes * Please delete as appropriate ** If you have not registered with HKUST Connect, please attach a completed HKUST Connect Registration Form.

Part II Project Information

Project Name:

Project Date: Time:

Place where project will be implemented:

Target Recipients: No. of Recipients:

Service Nature:

UN Sustainable Development Goal(s) that the project addressed:

No. of Volunteers Needed: HKUST Student - HKUST Staff -

Amount of Funding Requested:

Project Goals and Objectives:

1 Part III Community Partner

Organization:

Address:

Tel: Fax:

Contact person: Title:

Contact No.: Email:

Part IV Session Plan Provide a detailed session plan of the project, including preparation work, volunteer recruitment, briefing session, pre-service training, extra sessions or post service follow-up, if any. Use separate sheets if necessary.

Date / Time Activity / Description Materials / Manpower Remarks

2 Part V Budget Provide an itemized list of total amount of fund requested in the space below. Use separate sheets if necessary. The maximum amount of funding for each project is $2,000, depending on the scale and scope of the proposed service project. The funding could cover items such as transportation, activity related materials, facilities and equipment rental, etc. Guest speaker honoraria, stipend, souvenir, food and beverage are not eligible project expenses. Expenses Items Description Quantity Unit Estimated Price Amount e.g Transportation Coach service for from HKUST to Sham Shui Po 1 $1000 $1000 for 30 students

Terms and Conditions 1. Student Affairs Office (“SAO”) reserves the right to grant partial funding for a project, or to reject a proposal on the basis of insufficient information and details provided. 2. The approved funding will normally be reimbursed to successful applicants after submission of a project report which includes valid original receipts for expenses incurred, a financial report, and a reflective photo essay within one month upon project completion. SAO may however consider releasing an advance of partial funding to successful applicants to carry out the projects, if sound justifications are given. The actual amount is to be worked out case by case. 3. By submitting the project report, the applicant gives the University permission (without further consideration) to use the photographs and text for publicity purposes or in furtherance of the University's purposes or activities. 4. The project must be carried out according to the agreed details. Any deviation [e.g. dates, event nature, place, scale, type and no. of service recipients, etc.] must have the prior written approval from SAO. Failure to do so may result in the disqualification of the application and any advanced payment of subsidy shall be repaid to SAO immediately on demand. 5. If projects receiving advanced payment cannot be completed within the agreed timeframe for whatever reasons, the applicant shall repay the money in full to SAO immediately on demand.

Declaration I declare that the information given in support of this application is true and accurate. I have read and understand the Terms and Conditions set out above, and hereby sign to indicate my unreserved agreement with all its contents.

Signature of Applicant: Date:

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