Ucla American Indian Studies Center

UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]UCLA AMERICAN INDIAN STUDIES CENTERApproved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]REQUEST FOR FUNDING – ACADEMIC YEAR 2010-11Your name:UCLA Affiliation (student/faculty/staff/campus org/other):*If you are not affiliated with UCLA, please explain:Preferred email address: Preferred contact phone number:PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Date of the event: Location of the event:Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Financial contribution sought:1. Full name, title, phone number, and email address of the lead point person within the entity primarily responsible for the project:PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]1a. If you desire for the AISC to serve as the designated organization with primary responsibility for planning of this event, you may list Assistant Director, Rebecca Rosser, as the primary contact and it will be modified, if Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected] necessary, by the Center.2. Do you anticipate seeking the services of the AISC staff in coordinating the event? What positions and approximate number of hours?PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]3. If you are seeking funding for this project from other entities (at UCLA or otherwise), please list those entities and the amounts you have requested/been granted:PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]3a. Provide the full name, title, phone number, and email address of each point person within each respective partnering organization for budgetary and planning purposes.PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Final Instructions:Please attach a one-paragraph description of the event – including the proposed role of the AISC in the event -- and a detailed budget to this coversheet and return to:UCLA American Indian Studies Center PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]3220 Campbell HallAttention: Rebecca Rosser, Assistant DirectorApproved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]You may also submit the application and coversheet through email at: [email protected] Thank you for your application and efforts to work in collaboration with the AISC by providing programming related to Native people. Please note, however, that budgetary and other constraints prevent AISC from funding all applications submitted.PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Approved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected]Please provide a minimum of 30 days lead time on all requests. You will be notified about funding by the AISC Director, Angela Riley. If your project is funded by the AISC, we will need the following information when it is completed:PAGE 2 UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected] List of attendees (The AISC will provide a sign-in sheet) Flyer with all the event informationApproved: ______Date: ______Fund number: ______Project code:______AISC FUNDING REQUEST COVER PAGE UCLA AMERICAN INDIAN STUDIES CENTER3220 Campbell Hall Telephone: (310) 825-7315Telephone: (310) 825-7315Box 951548 Fax: (310) 206-7060Los Angeles, CA 90095-1548 Email: [email protected] Guest speaker form required to process payment (provided by the AISC) Itemized receipts for all expenditures (no later than 3 days after the event)Please note that this form will be shared with all partner organizations to ensure transparency and effective communication in the planning process.PAGE 2

Ucla American Indian Studies Center

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