Associated Student Government

Name of Organization:
President/Chair's Name
Advisor's Name
Advisor's Email
Contact Person
Contact Email
Number of Active Members
Total Number of Members
Dues Per Member
Will your org. be attending a National Conference during the 2012-2013 school year?: Yes No
Date of Conference
Location of Conference
Number Attending Conference
Vehicle Type: Private Car ESU Car ESU Mini Van ESU 12 Person Van
Round Trip Mileage
Airfare: Yes No
Ticket Price (Per Person)
Total Transportation Request
Lodging: Yes No
Room Rate
Number of Nights
Total Lodging Request
Registration: Yes No
Registration Per Person Cost
Total Registration Cost
Total National Conference Request
Regional Conference: Yes No
Dates of Conference
Location of Conference
Number Attending Conference
Vehicle Type: Private Car ESU Car ESU Mini Van ESU 12 Person Van
Total Mileage
Airfare: Yes No
Ticket Price Per Person
Total Transpertation Cost
Lodging: Yes No
Room Rates
Number of Nights
Total Loadging Request
Registration: Yes No
Registration Per Person Cost
Total Registration Cost
Total Regional Conference Request
Speaker(s): Yes No
Name of Speaker(s)
Aproximate Date of Speaker
Aproximate Date of Speaker
Printing and Plublicity: Yes No
Event(s)
Type of Plublicity
Cost of Plublicity
Aproximate Date of Event
Aproximate Dates
National Conference Total
Regional Conference Total
Speakers Total
Printing & Plublicity Total
Total Allocation Request
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(620) 341-1200
Emporia, KS 66801 |
1200 Commercial Street |