<%@LANGUAGE="JAVASCRIPT" CODEPAGE="1252"%> CLASS Fund Request

GEORGIA SOUTHERN UNIVERSITY
College of Liberal Arts and Social Sciences

Request for Internal Funds

  Name of requestor: Department:     

Date:

State your request:      

Cost: $       Amount requested from Dean's Office: $

If approved, transfer funds to speed chart: / account no.:  

Other sources of funding:

Signature of requestor: _______________________________ Date: _____________________

Approval of Chair: ___________________________________ Date: _____________________

This section for Dean's use only .

Approved / Amount approved: $____________ Denied

Deduct funds from/Pay by:

Operating Supplies & Expense Budget transfer to department Travel

Other:_____________________________

Special Projects Allocation Student Assistants

Other:________________________________________________________________

Dean's signature:_________________________________ Date:______________________

jpm ~ 4/05