University of Texas Health Science Center + Excellence Funds

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					           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
      university accounting.
Date:                                                        Page:   _____ of _____


Box #:                        Phone:                       Email:

Requesting Organization(s):

Project Description:

Project Goals:

Estimated Attendance :

Requested MSGA Funding
Organization 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
Co mments:
       Participant Reimbursement Addendum
                   Student    Amount      Use of   UNTHSC
Name       SSN
                     Box     Requested   Funding   Check #
Page _____ of_____

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