SNMA National CSC Fall 2017

SNMA Community Service

Grant Program

Purpose

The purpose of the SNMA Community Service Grant Program is to encourage local chapters to develop student-initiated service projects. By providing financial assistance to our chapters, this program aims to increase participation in community service across the nation. Chapter projects should comply with the mission of the SNMA and should ideally seek to fulfill the National Health Education & Disease Prevention and Pipeline Programs Service Protocols.

Eligibility

Any chartered SNMA chapter is eligible to apply.

Award

2 chapters award recipients to receive up to $200

Deadline

Sunday, December 15, 2017

Application Guidelines

Only complete applications submitted by the appropriate deadline will be considered.Applications should be submitted as a Word document (“chaptername_20xxCSGrant”) to . Chapters should demonstrate that other sources of funding have been sought.

Funding Restrictions

Grants will NOT be used to provide funding for speaker honoraria, food, or travel.

Upon Receiving a Grant

We require that a summary (maximum 500 words) and 2-3 photos (JPEG format) of the grant project be submitted to . For events that have already occurred, the summary and photos MUST accompany the application. For events that have not yet occurred, the summary and photos must be submitted within 30 days of project completion. Chapters must also submit copies of ALL receipts after completing project and the projects must be documented on the following quarter’s Chapter Activity Report. Grant projects may be chosen for presentation at the AMEC Community Service Poster Forum. Failure to complete any of these requirements may jeopardize a chapter’s ability to receive grants in the future.

In addition, chapters must be willing to showcase their projects during the

Annual Community Service Poster Forum which is hosted each year during SNMA's Annual Medical Education Conference. The Poster Forum provides an opportunity for award recipients to recognize SNMA’s continued commitment to community service.

SNMA Community Service

Grant Program Application

  1. Chapter Name: ______

Mailing Address: ______

______

E-mail: ______

Chapter Name on Bank Account: ______

  1. Project Leaders
  2. Chapter President

Name: ______

E-mail: ______

Telephone: ______

  1. Project Coordinator

Name: ______

E-mail: ______

Telephone: ______

  1. Project Description & Abstract

A. Project description (250 words or less, including any additional

Information that will assist in evaluating this project)

______

______

______

B. Project Abstract (100 words or less describing your project for possible submission to JSMNA and President’s Newsletter)

______

______

______

IV. Project Details

A. Title

i. Is this a National Protocol? __ Y __N

B. Number of proposed local chapter participants: ____

C. Describe your target audience (including expected number of attendees)

______

______

D. Goal of project (25 words of less)

______

E. How will you attain your goal? Please include specific objectives. (50

words or less)

______

______

V. Resources (Please describe any non-monetary support you anticipate receiving

from the following resources)

A. University: ______

B. Community: ______

C. Other SNMA chapters: ______

D. Other student groups: ______

E. Other health professionals: ______

F. Other: ______

VI. Finance & Budget

A. What additional funding sources were considered/received for this

project? (Please enter “0” if not considered)

i. Local chapter contribution: $ ______

ii. Collaborating groups: $ ______

iii. Other: $ ______

B. Amount requested: $ ______

C. Precise, itemized budget:

Funding Requested / Item Description
$
$
$
$
$
$
$
$
$
$

Please date this application, print and sign your full name

Project Coordinator ______

Signature ______Date ______

Chapter President ______

Signature ______Date ______

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