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Date of Request
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Contact Person
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Phone #
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Email
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Details of Request
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Department Name
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Department #
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Title of Funding Request
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Type of Dollars Requested
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Total Dollars Requested
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Please Specify Breakdown of Dollars
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(Breakdown of Dollars should equal Total Dollars Requested)
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Salary
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Fringes
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Operating
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Equipment
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Rationale for Request
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Check box if Department Head is knowledgeable of request
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Check box if Vice President is knowledgeable of request
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Check box if additional supporting documentation to follow
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Email to: jennifer.moe@und.edu
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A copy of the request will be sent to the contact email listed above |