Request for Financial Support

American Chemical Society – Orlando Local Section

Name of Contact Person:                                                                                                         

Organization:                                                                                                               

Address:                                                                                                                                  

Phone Number:                                                                                                                       

Fax Number:                                                                                                                           

E-mail Address:                                                                                                                       

Amount Requested:                                                                                                                 

Reason for Request/Proposed Project:

For consideration of request, the following must be attached: 

1)      Budget for proposal.

2)      Statement on how this project will affect ACS.

3)      For projects over $250, list sources and amounts of matching funds.

4)      Letter of support by an ACS member.

5)      Timeline of project.

If funds are awarded, a program report is required four weeks after the event.

Request for Financial Support must be forwarded to the Chair.  Requests will be considered at the next Executive Committee meeting, which occurs quarterly.