Project Fund Request This form is used for fund requests from Region 1 for ALL activities. Step 1 of 3 33% Project Title(Required)Type of activity PACE WIE YP EDU Other Project LocationProvide an address for the location of the event.R1 Section(Required)Select your SectionWA: BinghamtonWA: BuffaloWA: IthacaWA: RochesterWA: SyracuseCA: BerkshireCA: Green MountainCA: Mid-HudsonCA: Mohawk ValleyCA: SchenectadyCA: SpringfieldNA: BostonNA: MaineNA: New HampshireNA: Worcester CountyNA: ProvidenceSA: ConnecticutSA: Long IslandSA: New Jersey CoastSA: New YorkSA: North JerseySA: Princeton/Central JerseyChapterR1 Section Chair Email address A notification will be sent to your Section Chair when the application is completed.This field is hidden when viewing the formSubmission Date MM slash DD slash YYYY Event Date(Required) MM slash DD slash YYYY Pease allow for 30 days to process all funding requests. Contact(Required) First Last Address(Required) Street Address City State ZIP / Postal Code Email(Required) Phone(Required) Project DescriptionProject Type(Required)Employment Assistance ActivitiesCareer Development ActivitiesStudent Profesional AwarenessK-12 STEM Education ActivitiesGovernment ActivitiesSenior Member Elevation ActivitiesMembership OutreachOtherBrief Description(Required)Provide an overview of the event. Please describe how this will impact and recruit new IEEE members in your Section.Other information Will your Section have a booth for recruiting new members? Will members help with the activity? Will students help with the activity? Will this be a virtual event that everyone in the Region can attend? Will this event have PDH credit? Will IEEE-named awards be presented? Is there a financial benefit for IEEE members if funded (discount to attend, etc.)? Expected participants at the eventIEEE MembersNon MembersTotalProject Activities and Funding RequirementsTotal funds required for the activity.ActivityAmount Add RemoveThis is the total anticipated cost of the activity (not the amount of money you are requesting). Click on the + button to add items to this list. Example: 1. Awards $500 2. Advertising $300 3. Food $1000Total Funds requiredPlease sum up all of the amounts in the table above. Additional Funding SourcesSourcesAmountDetail Add RemoveThe region will try to match funds at a rate of 1:1. In the list above, you should provide all additional funding your have for the event. Click on the + button to add additional sources of funding. If the funding is for a specific detail (ie. awards) please specify.Total Funding SourcesPlease sum up all of the amounts in the table above. Total amount being requested from the region.This number should reflect what you hope to receive from the region. Please note that support does not typically exceed $750. Δ
