Educational Grant Request

Thank you for your interest in a Chapter Education Fund grant. Please note, this form must be completed by a restricted fund representative, alumnus advisor or house corporation officer. If you are unsure if you have the authority to sign for a CEF distribution, please email the Foundation at foundation@delts.org.

Requesting Entity Contact Information

First Name

Middle Initial

Last Name

Phone

I serve as the...

If other, please identify.

I am requesting on behalf of the...

Address Line 1

City

State

Zip

Request Type

Select Field

Request Amount

Requested Grant Amount

Requested Grant Frequency

One-time Request

Annual or Recurring Request

First-Ever Request

Educational Impact

Program Description

Please provide details on the program, scholarship, fellowship, or usage of the grant.

Program Outcomes

Please provide details on the educational impact of the grant.

Cost Estimates & Submission

Total projected cost of educational items, educational improvements, or conference/leadership experience/Karnea attendance, including registration fee, hotel rate (including tax), number of nights, number of rooms, travel costs – driving (number of cars, mileage) or airfare estimate as well as a projection for any meals, incurred during travel or meals not covered by the event registration:

For division conference, leadership experience, or Karnea – chapter name, school name, number attending, names attending.

I understand that all grants must be allocated and managed in accordance with Foundation policies and procedures, as well as, all applicable state and federal laws. Further, I understand that no monies will be paid in advance of the leadership experience. Grants will be paid following the conclusion of the experience and attendance is confirmed.

I hereby affirm

Please indicate preferred method of payment in the event your grant is approved. If physical check is requested, it will be made out to the individual above. If you request an ACH, you’ll be contacted for bank information over the phone. We cannot deposit money into your Valut or ChapterSpot account at this time.

I hereby submit this form in application of a grant from the Delta Tau Delta Educational Foundation.

This grant application does not constitute a grant. Grant commitments are made only after Foundation review. If necessary for new or unusual grant requests, legal counsel may be sought at the grantee’s expense to ensure compliance with IRS regulations. Please send all supporting documents and receipts to nick.zuniga@delts.org.