November 21, 2024 | H. Fred Simons African American Cultural Center

**** PLEASE NOTE THAT DUE TO COVID-19 THIS SUBMISSION IS SUBJECT TO CHANGE AS PER UNIVERSITY OF CONNECTICUT'S STUDENT UNION PROTOCOL****

Name of the Organization:*
Name of the Event:*
Funding Request Type:*
Please choose the type of funding requested.
Brief Overview of the Event:*
***Please make sure you submit this request up to one week prior to the event.***
Please enter the estimated total cost of your request (numbers only):*
What vendor/store do you plan to use the funds for?

If not applicable, please type N/A
Date of the event:*
MM slash DD slash YYYY

Please enter the estimated date the event will take place (mm/dd/yyyy).
Time of the event:*

: Hours

Minutes

AM/PM

Please enter the estimated time of the event.
Estimated number of attendees:*
Contact name:*

Please enter the first and last name of the person we can contact if need be.
Contact email:*

Please enter the best way we can reach you in order to get clarifying details or updates.
Event flyer:
Drop files here or

Max. file size: 250 MB.
AACC Director's Approval ****AACC Staff Use Only****
- Approved
- Not Approved
Date
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.