LSBE Technology Program

Name

Major and Year in School (if student) or
Rank and Department (if faculty or staff)

Address

Phone Number

Email

Please fill out with as completely as possible.

Expected starting and ending dates of the project (if relevant)
i.e. Fall 2005 - Spring 2006

Amount Requested

Itemized Expenses
i.e.
I. Hardware
  1. Mitsubishi XL8U Projector - $2007.36
  2. Toshiba Satellite M30 - $1,519.00
II. Software
etc.

Brief description of the project that will be funded by this grant, including a statement as to how it will impact LSBE students, faculty and staff

How will you assess the success of the project?

Brief description of external or internal funds available (if relevant, if none, type "none")

A copy of the generated email will be sent to the email address you provided.