Financial Resource Request Form

1. Financial Resource Request Form Financial Resource Request FormPurpose • The purpose of this tool is to standardize all financial resource requests so that we can evaluate and prioritize requests appropriately to facilitate delivery. For amounts over $5,000 please use a formal Business Case. • Type or print neatly in black ink and attach any additional information to clarify/support your request. • Please identify each event/activity for which you are asking funding and distinguish between them when answering the questions. • Submit this form to the Director of Marketing no later than 5 days prior to the weekly meeting in order to appear on that week’s agenda. Remember it will take up to 2 weeks before you will receive funding.Employee Requester InformationDepartment: Priority: High Med LowName: Email:Project Sponsor: Date:Project Title:

2. Please completely answer each of the following questions for eachof the events for which you are asking funding.Explain the purpose of the activity/event(s):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Who will benefit from each activity/event and how many people will be involved?____________________________________________________________________________________________________________________________________________________________________________________________________Are any other departments involved in the activity/event other than your own?____________________________________________________________________________________________________________________________________________________________________________________________________What publicity do you have planned for the activity/event(s)?____________________________________________________________________________________________________________________________________________________________________________________________________Besides this, what other funding sources have you explored?____________________________________________________________________________________________________________________________________________________________________________________________________Have you received any funding from the Department this year? ___ Yes ___ NoIf yes, how much? $ _______________Has Senior Management already approved the activity/event(s)? ___ Yes ___ No Please completely answer each of the following questions for eachof the events for which you are asking funding.Explain the purpose of the activity/event(s):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Who will benefit from each activity/event and how many people will be involved?____________________________________________________________________________________________________________________________________________________________________________________________________Are any other departments involved in the activity/event other than your own?____________________________________________________________________________________________________________________________________________________________________________________________________What publicity do you have planned for the activity/event(s)?____________________________________________________________________________________________________________________________________________________________________________________________________Besides this, what other funding sources have you explored?____________________________________________________________________________________________________________________________________________________________________________________________________Have you received any funding from the Department this year? ___ Yes ___ NoIf yes, how much? $ _______________Has Senior Management already approved the activity/event(s)? ___ Yes ___ No

3. If no, why?____________________________________________________________________________________________________________________________________________________________________________________________________Please supply projected cost/benefit information for the activity/event for which you areseeking funding. Include detailed figures on sources of projected costs and projectedbenefits. Indicate if you plan on getting, or that you have gotten, any services or itemsdonated.Event/Activity: ____________________________________ Cost/Benefit Analysis WorksheetProject CostsIncremental Costs Description High Low Total CostsProject BenefitsIncremental Benefits Description High Low Total Benefits % Benefits/CostsOffice use only: If no, why?____________________________________________________________________________________________________________________________________________________________________________________________________Please supply projected cost/benefit information for the activity/event for which you areseeking funding. Include detailed figures on sources of projected costs and projectedbenefits. Indicate if you plan on getting, or that you have gotten, any services or itemsdonated.Event/Activity: ____________________________________ Cost/Benefit Analysis WorksheetProject CostsIncremental Costs Description High Low Total CostsProject BenefitsIncremental Benefits Description High Low Total Benefits % Benefits/CostsOffice use only:

4. TOTAL Amount Requested from Employee: ____________Funding decision date: ___/___/___$ ______________________ Funding decision vote: ___/___/___Please sign and date this request for funding:______________________________________________________________________________Name DateResource Request Approval (required signatures)Requester: Project Sponsor:Date: Date:Name: Name:Signature: Signature:Director of Marketing:Date:Name:Signature: TOTAL Amount Requested from Employee: ____________Funding decision date: ___/___/___$ ______________________ Funding decision vote: ___/___/___Please sign and date this request for funding:______________________________________________________________________________Name DateResource Request Approval (required signatures)Requester: Project Sponsor:Date: Date:Name: Name:Signature: Signature:Director of Marketing:Date:Name:Signature: