Lehigh University
Chaplain’s Office 2014 - 2015
Religious Group Request for Funding Support
Religious Groups who request funding support from the Chaplain’s Office must formally apply for funding and agree to the conditions included in this form.
Name of Religious Group/Organization:___________________________________________
Description of Program for which funding is requested:______________________________
______________________________________________________________________________
Amount of the Request:_________________________________________________________
What will the money be specifically used for:______________________________________________
_________________________________________________________________________________________
If you are requesting money for off campus activities or travel, have those members of your group participating in the travel been identified and has each one filled out a Lehigh University waiver?
__________________________yes ________________________no
N.B. No moneys will be transferred for travel until a Lehigh waiver has been signed by every person involved in the travel.
What other funding has been secured or is being requested? Please give amounts and source:
______________________________________________________________________________
______________________________________________________________________________
Account to which money is to be transferred:__________________________________
You agree to provide a report on activity and how the money was used within 30 days of the activity (copies of receipts required):
___________________________________________
Signed by person authorized by religious group
____________________________________________________________________________
For office use only: Action taken: _____approved _________disapproved ____hold
Notes: