CACSSF & WFAC Grant Application

Save my progress and resume later | Resume a previously saved form

Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Your Email:

A Password:

Confirm Password:

Password must contain the following:

12 Characters
1 Uppercase letter
1 Lowercase letter
1 Number
1 Special character

The deadline for CACSSF and Wellness Fund application is Friday, February 13th at 11:59pm.
If you have questions about the funding proposal submission process, please email: wellnessfee@berkeley.edu (Wellness Fund) or cacssf@berkeley.edu (Student Services Fees).

Proposal

Name of Proposed Program, Service or Project

Please select a proposal type

Contact Information

Someone who can provide more details about the project, service, or program.

First Name

Last Name

Title

Role on Campus/Campus Department

Berkeley Email

Phone Number

Previous CACSSF Funding

Has this group received CACSSF previously?

Previous Contact Name

Previous Contact Email

Student Co-Sponsor

Student Co-Sponsor Name

Student Co-Sponsor Email

Staff Advisor

Does this group have an Staff Advisor? See here for a list of staff advisors.

Advisor Name

Advisor Email

Proposal Information

Describe the program or service, including the student needs this proposal would address as well as the goals of this program (Limit: 300 words)

Describe the consultation process, Which students and campus departments were consulted and the number who provided input? (Limit: 300 words) Consultation should include elected student representatives (e.g., Graduate Assembly delegates or executive officers, ASUC senators or executive officers) and any campus partners that will be involved.

Describe the direct benefit(s) to students, which student populations will be served (e.g., graduate students, underserved communities), the estimated number of students who will be impacted, how you arrived at that estimate, and what metrics you will use to measure impact. (Limit 400 words)

Are there similar programs or services available on campus? If so, describe these services and how your proposal differs from them. (Limit 150 words)

Please provide a timeline for the actions you plan to take if awarded funding, including plans for partial funding. (Limit: 250 words)

If this is a multi-year funding request, what is your plan for sustaining this program, project, or service? Who will oversee it in future years? Please list one contact for future oversight and include how they will be involved in the project. (Limit: 250 words)

Which grant is the group applying for?

If applying for Wellness funding instead of Student Services Fee funding, please describe how this proposal matches the intent of the Wellness Fee Referendum. (Limit: 100 words)

Funding Information

Total Funding Requested

Do not enter a "$", just enter a number

If full funding is not available, could the project, program, or service be implemented with partial funding?

Please describe the highest priority components of your proposal and their cost. (Limit: 150 words)

Where else have you requested funding, including past and current funding proposals? Please include dates submitted, amounts requested, and the outcome of your request. (Limit: 150 words)

Campus Partner Approval

The Campus Partner Approval form is required for student proposals that include a collaboration with one or more campus departments. A separate form is required for each department.

Campus Partner Approval Form:
https://docs.google.com/fdocument/d/1T5prihFkw9UbsNOMa3Czbc2SegRHXKg5YHlwIPoWw-s/edit?tab=t.0

Upload Campus Partner Form(s)

Budget

Please paste a shareable link to in the box below, to your complete, itemized budget and break down the major categories of expenses for your program line by line in a spreadsheet.

If you propose purchasing a specific product or service, please list its cost.
If you are propose paying campus staff, please include the full-time equivalent (FTE) salary and benefits (please use 46% + 1.55% for the benefits and GAEL calculations respectively), and percentage to be paid by CACSSF.
If you propose paying student staff, please specify whether the student will be a graduate or undergraduate student, the proposed weekly hours and hourly wage.
Please budget for the entire program, and indicate which line items you are requesting that CACSSF fund.
If your proposed service will receive funds from other sources, please include whether the funds are confirmed, being sought, in the process of being fundraised, etc., and what they will be used for.

Please feel free to use a copy this template for the budget: https://docs.google.com/spreadsheets/d/1lIicUQzR1KbJxrC2-WmYGyAHVTK6W7iTN5CUqemYTmw/edit?usp=sharing

Please make sure the spreadsheet is shared with anyone in the UC Berkeley group (has a berkeley.edu email address).

Link to Budget

Save my progress and resume later | Resume a previously saved form

Contact Information