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Wellness Event Funding Request Form
Date:
04/23/2024
Name:
Full Name -
First -
(Required)
Last -
(Required)
Affiliation:
Student
Faculty
Staff
E-mail:
(Required)
Center and Unit/Program:
Select One Choice Below
Center for Distance Learning
Central New York Center
Coordinating Center
Genessee Valley Center
Graduate Studies
Harry Van Arsdale Jr. Center for Labor Studies
Hudson Valley Center
International Programs
Long Island Center
Metropolitan Center
Niagara Frontier Center
Northeast Center
School of Nursing
(Required)
Title of Event:
(Required)
Dates of Activity:
Start:
(Required)
End:
(Required)
Location of Event:
(Required)
Description of Event:
(Required - It is recommended that you create this description in another word processing program and then copy and paste the text into this field.)
Total Funds Requested:
$
(Required - Numbers only, do not enter any text or special characters in this field.)
Estimated Attendance:
Event Coordinator:
Would you like an event coordinator on site to help with this event?
Yes
No
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