Rocky Mini-Grant - Groups (On Campus Event)

This form must be completed before receiving approved Rocky mini-grant funding. Your project must have taken place for you to complete this form.

Please complete only ONE application per student group.

Be ready to provide the following:

Your student organization's chart string;
The attendance of your on campus events;
A summary in 400-600 words of what you learned and why you think it was a valuable experience;
Your best 3-5 pictures in jpg format, please be ready to write captions as well;
Copies of your original receipts saved as a pdf.

Final requirements must be completed within 30 days of your event or project. If your event or project takes place after June 1st, all final requirements must be received by June 30th.

Has your project taken place? *

Yes No

Full Name *

First Name Last Name

Class Year *

Full Dartmouth E-mail Address: *

No alias'. ex. first.m.last.17@dartmouth.edu

Cell Phone Number *

ex. 603-646-5000

HB *

ex. HB6082

Name of student organization you represent: *

Your student organization's chart string *

Make copies of your original receipts, save them as a pdf (PDF's ONLY PLEASE!!) and upload them here. Make sure the receipts are clearly marked to explain the expenses. *

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Briefly describe your project in 2-3 sentences. *

When did your project end? *

Month Day Year

Hour Minutes AM/PM Option

On a scale of 1-5 (1=least successful, 5=most successful)...how successful was the project for your organization? *

1

2

3

4

5

1 is Worst, 5 is Best

Please explain: *

Please give a summary in 400-600 words of what you learned and why you think it was a valuable experience. **Please be sure to spell check. This will be published as a Rockefeller Center blog post and will list you as the author. *

What was the actual attendance of your on-campus event? (If a series of events, list the attendance of each one): *

Did The D write an article for your event or program? *

Yes No

If yes, please supply the URL:

You were required to take pictures of your project during the implementation. Please choose the best 3-5 photos and upload them as jpegs here.

Photo 1 *

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Caption for photo 1 *

Photo 2 *

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Caption for photo 2 *

Photo 3 *

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Caption for photo 3 *

Photo 4

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Caption for photo 4

Photo 5

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Caption for photo 5

For off campus projects:

In the mini-grant application, you were asked how you plan to share what you have learned with others on campus.

Please explain how and when you shared what you learned with others on campus. *

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What date did you return to campus after attending this event?

By checking YES to this box, I understand that my name, bio, associated student organization, project information, and photos will be used in Rockefeller Center outreach and marketing. This may include, but is not limited to: web site, blog, facebook, flickr, posters/flyers, brochures, youtube, newsletters, twitter, and annual report. *

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