* 1. Club:

* 2. Year club was established:

* 3. Budget representative name and email address:

* 4. Club website address:

* 5. What is your current tier level?

* 6. Are you applying for a different tier level for 2012-2013?

* 7. If yes, for what tier level are you applying?

* 8. What are the annual dues PER MEMBER PER YEAR?

* 9. How many members do you currently have? List undergraduate, graduate, faculty/staff.

* 10. Is your club required to have general liability insurance through your regional or national affiliation?

* 11. Do you have a non-UC student coach for your club?

* 12. If yes, please add his/her:
Email address

* 13. If you have a coach, do you pay him or her?

* 14. What are the goals and purpose of your club sport?

* 15. If you are applying for a new Tier level, please explain here.

* 16. List your club achievements for the 2011-2012 academic year.

* 17. What is your general practice schedule (day/time/location)?

* 18. Please list any major future plans for your club sport (fundraising, recruitment, tournaments, coaching changes/additions, etc.).

* 19. List ALL of your events from July 1, 2011 until June 30, 2012. For example, on one line, list:
Event name, location, date

Example 1: Practice, UC Nippert Stadium, August 21, 2011
Example 2: Match versus Ohio State, Ohio Stadium, January 5, 2012

* 20. List the capital your club currently owns. For each item list item name, quantity, approximate cost, where the item is stored, and when the item was purchased. Include supplies, equipment, clothing, etc.

Example 1: Soccer balls, 10, $25/each, purchased in 2005, stored in adviser's office
Example 2: Jersey's, 20, $10/each, purchased in 2011, stored at Campus Recreation Center

* 21. At this point, please fill out the Budget template: http://www.uc.edu/content/dam/uc/sald/docs/Budget%20Template%202012.2013%20Supplemental%20Sheet.xls

Once the form is completed, email Nicole Mayo at nicole.mayo@uc.edu with the above attachment. You'll then set up a meeting with Nicole to go over off-campus bank account statements (Cinco, PNC, etc) and the club sports account statement to review funding needs for 2012-2013.