Guidelines for Requesting Financial Assistance
Medical Student Government Association
The Medical Student Government Association (MSGA) of the University of North Texas
Health Science Center is dedicated to budgeting and dispersing funds to clubs,
organizations, and student lead activities which promote the osteopathic profession,
provide service to the community, and promote excellence in our medical education.
The following process provides a standard for requesting and determining need in an
equitable manner. Please complete all information requested.
1. Request reimbursement by completing the attached page of information.
2. When requesting funds from the MSGA please consider how your request will
impact the following:
a. Promotion of the Osteopathic Profession and UNTHSC/TCOM
b. Outreach to the student body of UNTHSC/TCOM
c. Benefit to the community
d. Number of persons reached by your project
3. Provide sufficient time for MSGA to review the information and vote on funding.
This process can take up to 60 days.
4. The requesting individual is required to present the request to the MSGA council.
5. Once the review is completed, the individual will be informed of the outcome by
a member of the executive council.
6. If the outcome is unacceptable, a second presentation to MSGA will be arranged
through the MSGA secretary. Additional information should be presented at this
time to proved further insight to the request.
7. The funds will be disbursed in the manner determined by university policy.
Please keep receipts for review by the MSGA treasurer, Student Affairs, and
Date: Page: _____ of _____
Box #: Phone: Email:
Estimated Attendance :
Requested MSGA Funding
Additional Funding Sources
Value of Donated Services
Value of Donated Supplies
Total Budget for Project
For use by MSGA
Date Rev iewed : Council Vote: For Against Abstain
Participant Reimbursement Addendum
Student Amount Use of UNTHSC
Box Requested Funding Check #
Page _____ of_____