External Funding Pre-approval Form

Please make an appointment with me, prior to submitting this form. Once this form is submitted, it will be shared with the Executive Cabinet. You must have their approval before moving forward on any kind of external funding. Incomplete forms will be returned.

~Linda S Lephiew, Grants Administrator

870/864.8446, llephiew@southark.edu

Name and position of person submitting this form

Email address

Department

Supervisor's Name

Today's Date

Date

Due date for Grant Application

Date

Project Title

Type of funding

Funding Agency and Grant Number, if applicable

Are you registered on Grants.gov?

YesNo

Project Start Date

Date

Project End Date

Date

Purpose or need for proposed project

What will the project entail? (major activities and deliverables)

With which elements of SouthArk’s Strategic Plan does your proposal align? Choose all that apply.

TEAM--Participation, Cooperation, ProgressHUB--Heart, Center, CoreRESOURCES--Security, Provision, ExpansionINCLUSION--Access, Awareness, ValueVIABILITY--Quality, Relevance, SuccessEXPERIENCE--Engage, Support, Grow

Explain how the project aligns with Strategic Initiative 1--TEAM

Explain how the project aligns with Strategic Initiative 2--HUB

Explain how the project aligns with Strategic Initiative 3--RESOURCES

Explain how the project aligns with Strategic Initiative 4--INCLUSION

Explain how the project aligns with Strategic Initiative 5--VIABILITY

Explain how the project aligns with Strategic Initiative 6--EXPERIENCE

Total Anticipated Budget

Cost to SouthArk

Is a cash match required?

YesNo

Are in-kind donations required?

YesNo

If yes, please give details.

Does the grant require any components or positions to be institutionalized? If so, explain.

Which college departments will be involved?

Which external partners are required?

Who will serve on the grant development team?

Type in your name in lieu of a signature. Do not attempt to add an electronic signature.

Email address of immediate supervisor