Student Chapter Activity Grant Application Form

OSA provides all Student Chapters, in good standing, with the opportunity to apply for grant funding to support Chapter events and promotion. Grants of up to $1,000 USD per program are available. Please complete the form below to apply for a grant.

Note: All applicants must complete Section 1, only complete the other sections that are relevant for to your program/event.

Note: Applications will not be accepted from Student Chapters that have not submitted an Annual Report and/or a program report for activity grants awarded in the current or previous year.

Section 1: Contact Information

Name of Student Chapter:

Contact Person for the Activity Grant:

Phone Number:

Email Address:

Mailing Address:

Section 2: Cross Chapter Activities

Complete this section if you are applying for funding to support activities with other OSA Student Chapters. If not, skip to Section 3.

Name of activity:

Date of proposed activity:

Location of proposed activity:

List the Chapter members that will participate in the planning and implementation of this program:

List the other Chapters that will participate in this program:

Description of the activity: Limit: 100 words

Number of expected participants:

Summarize the program’s planning, marketing and implementation phases (Important: include timing for each phase.): Limit: 100 words

What outcomes do you expect; both immediate and long term. Limit: 100 words

Please provide an itemized list of all expenses associated with this project.

Principal Budget items:	Amount
Total estimated cost:
Amount requested from OSA:

If the amount requested from the OSA is less than the total estimated cost listed above, please provide a list of the other sources of funding, including the amount requested and the status of that request:

Has your Chapter participated in this event previously?
Yes No

If yes, please indicate when and briefly describe the event and results.

Section 3: Recruitment/Chapter Promotion Activities

Complete this section if you are applying for funding to support activities that promotion your Chapter and/or to recruit members. If not, skip to Section 4.

Name of activity:

Date of proposed activity:

Location of proposed activity:

List the Chapter members that will participate in the planning and implementation of this program:

Description of the activity: Limit: 100 words

Who is the target audience for this program?

Number of expected participants:

Summarize the program’s planning, marketing and implementation phases (Important: include timing for each phase.): Limit: 100 words

What outcomes do you expect; both immediate and long term. Limit: 100 words

Please provide an itemized list of all expenses associated with this project.

Principal Budget items:	Amount
Total estimated cost:
Amount requested from OSA:

If the amount requested from the OSA is less than the total estimated cost listed above, please provide a list of the other sources of funding, including the amount requested and the status of that request:

Has your Chapter participated in this event previously?
Yes No

If yes, please indicate when and briefly describe the event and results.

Section 4: Social Function

Complete this section if you are applying for funding to support social activities/functions for your Chapter. If not, skip to Section 5.

Name of activity:

Date of proposed activity:

Location of proposed activity:

List the Chapter members that will participate in the planning and implementation of this program:

Description of the activity: Limit: 100 words

Number of expected participants:

Please provide an itemized list of all expenses associated with this project.

Principal Budget items:	Amount
Total estimated cost:
Amount requested from OSA:

If the amount requested from the OSA is less than the total estimated cost listed above, please provide a list of the other sources of funding, including the amount requested and the status of that request:

Has your Chapter participated in this event previously?
Yes No

If yes, please indicate when and briefly describe the event and results.

Section 5: Other Activities

Complete this section if you are applying for funding to support Chapter activities that do not fall within the categories provided above. If not, scroll down and click “Submit”.

Name of activity:

Type of activity:

Date of proposed activity:

Location of proposed activity:

List the Chapter members that will participate in the planning and implementation of this program:

Description of the activity: Limit: 100 words

Target audience:

Number of expected participants:

Summarize the program’s planning, marketing and implementation phases (Important: include timing for each phase.): Limit: 100 words

What outcomes do you expect; both immediate and long term. Limit: 100 words

Please provide an itemized list of all expenses associated with this project.

Principal Budget items:	Amount
Total estimated cost:
Amount requested from OSA:

If the amount requested from the OSA is less than the total estimated cost listed above, please provide a list of the other sources of funding, including the amount requested and the status of that request:

Has your Chapter participated in this event previously?
Yes No

If yes, please indicate when and briefly describe the event and results.