Form A
Fiscal Year 2012 Activity Fee Budget Application SUMMARY: FORM A
(Click on the gray area to enter your information) 3 Questions on this page
Organization Name _________________________ Budget Amount Requested _________ Must equal "Net Amount Requested"
at bottom of Form B
Total number of Active Members
Budget Preparer(s) listed below:
Name __________________________ Email: ___________________________
Office held within Organization (i.e. president, treasurer, advisor):______________________________
Name __________________________ Email: ___________________________
Office held within Organization (i.e. president, treasurer, advisor):______________________________
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1. PURPOSE OF ORGANIZATION: Briefly explain the purpose of your organization and how you plan to
accomplish the purpose and mission of your organization. Explain how your organization impacts the
MSUM campus and community.
Click on the yellow rectangle to begin entering info.
hit"enter" key at the end of the gray area on each line
to go to the next line in your narrative
All text should be visible within the gray box
when you are finished with your narrative.
2. COST CHANGES: What are the reasons for cost differences between your FY11 request and/or allocation this FY12 request
If you did not receive SABC funds for FY11 do not complete this question.
Click on the yellow rectangle to begin entering info.
hit"enter" key at the end of the gray area on each line
to go to the next line in your narrative
All text should be visible within the gray box
when you are finished with your narrative.
3. ACTIVE AND FISCALLY HEALTHY: Explain how your organization will continue to grow after this
year and how you will ensure that your organization will spend its budget wisely? (what financial controls
will you follow?) What plans/strategies will you use to make sure you keep your members from this year to next year?
Click on the yellow rectangle to begin entering info.
hit"enter" key at the end of the gray area on each line
to go to the next line in your narrative
All text should be visible within the gray box
when you are finished with your narrative.
Page 1
Enter Dollar amounts in column F gray areas only FORM B Fiscal Year 2012 Request
Income FY 12 REQUEST Enter your estimate of income
for Fiscal Year 2012; dues collected from members,
9380 Advertising Sales grants from outside sources, sale of tickets,clothing, etc.
9386 Entry Fees
9398 Ticket Sales/Event admission Revenue is any type of income or fundraising
9199 Dues/donations from members money that is available to you.
9803 Grants from department or outside
source(includes non-tax deductible donations) Note: For every dollar of revenue that comes in, you
TOTAL INCOME: $0.00 should have a matching amount of expense
listed below, unless you expect to raise more than
you spend, in which case you wouldn't need SABC funds.
Expenditures(expense by code number)
Fill in your best estimate of each type
0910 Salaries/Students & Fringes of expense you anticipate for next year.(dollar amount)
If you put a dollar amount next to
1010 Rents & Leases any Expenditures expense code, you will need to
1140 Advertising show on Form C how you calculated that amount.
1310 Insurance You must complete Form C unless you are not
1410 Printing anticipating any expenses for next year in which
1870 Contracts for Officials, Speakers, case you do not need to submit a budget
Sodexo catering, request
201X Postage
2020 Network services (data line
phone or computer)
2160 Motor Pool or student car ………….. ……. "Motor Pool" for in-town use only(don't include on
form 'T' put it on Form 'C')
XXXX Other Expense not listed above ………….. ……. "Other" is for any expense type you don't see
listed anywhere else on this page
2720 Travel by student(s)Out of town trips ……………… ……. *If you fill in a dollar amount for travel you must
2891 Fees/Memberships etc. complete Form T "Travel" Do not put travel on
3000 Supplies Form C "Expense Worksheet".
4000 Equipment (List)
7041 Stipends ……………… ……. Stipend is a small fee paid to an executive
member of your organization rather than salary
TOTAL EXPENSE ESTIMATE $0.00
Net Request. Subtract Income from Expenses $0.00 This amount is your FY2012 budget request to SABC
If this net request number is negative( ), no funds are awarded by SABC This should equal the amount you list on Form A, top right gray box
"Budget amount requested"
12/7/2011 ecc7e5ee-6805-4de2-8011-5831e37b6b30.xls
Form C "Expense worksheet"
2012 Form C EXPENSE WORKSHEET
Breakdown of estimated expenses for FY 2012
Enter dollar amounts where indicated
1. Use the expense sections below to detail how you plan to spend any budget allocation
from SABC.
2. Show “math work” for each expense section where you have a dollar amount listed. Use
the space directly below the line item. If you need more room, use the "Extra Form C" tab to sh
do not enter any dollar amounts on Extra Form C, use it only for space to show your work
Description Amount of Expense
0910 Student Salaries& 7091 Stipends may be entered here
“Show your work” how you calculated this expense (use space below)
1010 Rents & Leases
“Show your work” how you calculated this expense (use space below)
1140 Advertising(radio, newspaper)
“Show your work” how you calculated this expense (use space below)
1310 Insurance
“Show your work” how you calculated this expense (use space below)
Page 3
Form C "Expense worksheet"
1410 Printing (flyers,posters,copies)
“Show your work” how you calculated this expense (use space below)
1870 Contracted Services (Sodexho, speakers, entertainers, campus security, theatre lighting)
“Show your work” how you calculated this expense (use space below)
2010 Postage (U.S Mail, FedEx, UPS or other shipping methods)
“Show your work” how you calculated this expense (use space below)
2160 Motor Pool or student car for in-town use
“Show your work” how you calculated this expense (use space below)
2020 Network Services (data line incl phone and computer)
“Show your work” how you calculated this expense (use space below)
Page 4
Form C "Expense worksheet"
2891 Fees & Memberships (annual fees or memberships not registration fees for conferenes or tournaments
or fees paid to be in a tournament, those go on Form T Travel)
XXXX Other Expenses not listed on this page
“Show your work” how you calculated this expense (use space below)
3000 Supplies (small supplies)
“Show your work” how you calculated this expense (use space below)
4000 Equipment (uniforms,cameras, computer)
“Show your work” how you calculated this expense (use space below)
Page 5
Form C "Expense worksheet"
“Show your work” how you calculated this expense (use space below)
TOTAL OF ALL EXPENSE ESTIMATES
Page 6
Form C "Expense worksheet"
y budget allocation
ar amount listed. Use
the "Extra Form C" tab to show your work
for space to show your work.
unt of Expense
>>>>>> x $ 19.00 =
enter # of students above^ enter # of days ^
Other Cost" not listed above =
Total Trip Cost Trip #1
Purpose of Trip #2 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x =
plus $5.00/day per MSUM vehicle +
Airfare/ Train total Cost Trip#2 +
Total Mileage Cost Trip #2…………… =
Registration or Entry Fee………………. =
Calculating Meals Expense Hotel Lodging Costs Trip #2…………… =
Enter in gray area to right>>>>>>> x $ 19.00 =
enter # of students above^ enter # of days ^
Other Cost" not listed above =
Total Trip Cost Trip #2
Purpose of Trip #3 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x =
plus $5.00/day per MSUM vehicle +
Airfare/ Train total Cost Trip#3 +
Total Mileage Cost Trip #3……………… =
Registration or Entry Fee………………. =
Calculating Meals Expense Hotel Lodging Costs Trip #3…………… =
Page 15
Form T Travel
Enter in gray area to right>>>>>>> x $ 19.00 =
enter # of students above^ enter # of days ^
Other Cost" not listed above =
Total Trip Cost Trip #3
Purpose of Trip #4 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x =
plus $5.00/day per MSUM vehicle +
Airfare/ Train total Cost Trip#4 +
Total Mileage Cost Trip #4……………… =
Registration or Entry Fee………………. =
Calculating Meals Expense Hotel Lodging Costs Trip #4…………… =
Enter in gray area to right>>>>>>> x $ 19.00 =
enter # of students above^ enter # of days ^
Other Cost" not listed above =
Total Trip Cost Trip #4
Subtotal Trips 1 through 4
Subtotal Trips 5 through 8
Grant Total Travel Expenses……………………………….
Page 16
Form T Travel
use a personal care.
lease use the "EXTRA FORM T" tab
r Mile( enter .48 or .55 or .43 based on type of vehicle)
e personal vehicle)
0 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
$0.00 automatically calculated
r Mile( enter .48 or .55 or .43 based on type of vehicle)
e personal vehicle)
0 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
$0.00 automatically calculated
r Mile( enter .48 or .55 or .43 based on type of vehicle)
e personal vehicle)
0 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
enter dollar amount
enter dollar amount
Page 17
Form T Travel
$0.00 automatically calculated
$0.00 automatically calculated
r Mile( enter .48 or .55 or .43 based on type of vehicle)
e personal vehicle)
0 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
enter dollar amount
enter dollar amount
$0.00 automatically calculated
$0.00 automatically calculated
$0.00 automatically calculated
$0.00 automatically calculated
$0.00 Should equal what you entered
on Expense line 2720 on Form B
Page 18
Extra Form T
TRAVEL FORM T
Fill in ONLY Gray Boxes for each trip
Cost per mile is based on $.55 per mile if you use a 12 passenger MSUM van and $.48 per mile if you use
a MSUM mini-van, $.43/mile if you use a MSUM car & per mile reimbursement of $.41/mile if you use a personal care.
You must also add on $5.00 per day, per each vehicle, if you are using MSUM state vehicles.
There is room on this tab to enter 4 trips. If you need another spreadsheet to add more than 4 trips, please use the "EXTRA FO
Purpose of Trip #5 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x
plus $5.00/day per MSUM vehicle
Airfare/ Train total Cost Trip#5
Total Mileage Cost Trip #5………………
Registration or Entry Fee……………….
Calculating Meals Expense Hotel Lodging Costs Trip #5……………
Enter in gray area to right>>>>>>> x $ 19.00
enter # of students above^ enter # of days ^
Other Cost" not listed above
Total Trip Cost Trip #5
Purpose of Trip #6 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x
plus $5.00/day per MSUM vehicle
Airfare/ Train total Cost Trip#6
Total Mileage Cost Trip #6……………
Registration or Entry Fee……………….
Calculating Meals Expense Hotel Lodging Costs Trip #6……………
Enter in gray area to right>>>>>>> x $ 19.00
enter # of students above^ enter # of days ^
Other Cost" not listed above
Total Trip Cost Trip #6
Purpose of Trip #7 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x
plus $5.00/day per MSUM vehicle
Airfare/ Train total Cost Trip#7
Total Mileage Cost Trip #7………………
Registration or Entry Fee……………….
Calculating Meals Expense Hotel Lodging Costs Trip #7……………
Enter in gray area to right>>>>>>> x $ 19.00
Page 19
Extra Form T
enter # of students above^ enter # of days ^
Other Cost" not listed above
Total Trip Cost Trip #7
Purpose of Trip #8 Destination City & State Miles(round trip) x Cost per Mile( enter .48 or .55 o
(name of workshop or tournament) (.41/mile personal vehicle)
x
plus $5.00/day per MSUM vehicle
Airfare/ Train total Cost Trip#8
Total Mileage Cost Trip #8………………
Registration or Entry Fee……………….
Calculating Meals Expense Hotel Lodging Costs Trip #8……………
Enter in gray area to right>>>>>>> x $ 19.00
enter # of students above^ enter # of days ^
Other Cost" not listed above
Total Trip Cost Trip #8
TOTAL COST TRIPS 5-8
Page 20
Extra Form T
you use a personal care.
s, please use the "EXTRA FORM T" tab
t per Mile( enter .48 or .55 or .43 based on type of vehicle)
mile personal vehicle)
= 0 automatically calculated
+ enter dollar amount
+ enter dollar amount
= $0.00 automatically calculated
= enter dollar amount
= enter dollar amount
= $0.00 automatically calculated
=
$0.00 automatically calculated
t per Mile( enter .48 or .55 or .43 based on type of vehicle)
mile personal vehicle)
= 0 automatically calculated
+ enter dollar amount
+ enter dollar amount
= $0.00 automatically calculated
= enter dollar amount
= enter dollar amount
= $0.00 automatically calculated
=
$0.00 automatically calculated
t per Mile( enter .48 or .55 or .43 based on type of vehicle)
mile personal vehicle)
= 0 automatically calculated
+ enter dollar amount
+ enter dollar amount
= $0.00 automatically calculated
= enter dollar amount
= enter dollar amount
= $0.00 automatically calculated
Page 21
Extra Form T
=
$0.00 automatically calculated
t per Mile( enter .48 or .55 or .43 based on type of vehicle)
mile personal vehicle)
= 0 automatically calculated
+ enter dollar amount
+ enter dollar amount
= $0.00 automatically calculated
= enter dollar amount
= enter dollar amount
= $0.00 automatically calculated
=
$0.00 automatically calculated
RIPS 5-8 $0.00 automatically calculated
Page 22