ࡱ> SURi bjbj^^ 48<j<j '~ ~ %%%8],l%4"l4n4n4n4n4n4n4o6%9n4n44,,,Fl4,l4,,\13U%82X4404,2\990393,n4n4J49~ Y : Request for Financial Support for Assessment Activities Department Signature of Chair requesting funds ______________________ _____________ College Deans Signature Date Total Amount Requested Description of assessment expenditure. Please provide specifics of your request: (Please attach extra sheet if needed) Expenditures: ItemDescription of itemCostAssessment activityAnalysis of Assessment dataPostage (if applicable)Printing/duplicating (if applicable)Other feesTotal amount requested:= How frequently do you anticipate needing these funds? (Highlight your choice) Annually Every 2 years Every 3 years One time request Other (please explain): ____________________________________ Is this the first-time expenditure? If no, where did you get the funds to support these activities before? (Please attach extra sheet if needed) If yes, what are your plans moving forward to support this expenditure within your department/college? (Please attach extra sheet if needed) Departmental Assessment Plan Please submit the most recent assessment plan and report of assessment findings (feedback loop) for your department if money was requested in past 5 years. The department must send a description of the assessment findings and how they were used within the department using the assessment plan template below. Funds will not be awarded without an assessment plan. Academic Program Assessment Plan: (Please attach extra sheet if needed) Program Purpose Statement: Provide the program purpose statement (formerly Mission statement) and its relationship to the University mission specifically looking at how the program is an educational driver, cultural driver, and/or economic driver: Program Goals/Objectives: What are the programs goals and objectives? How are these programs goals/objectives assessed? What does your latest assessment show for these program goals/objectives? Learner Outcomes of Program: What are the learner outcomes for the program that will be supported by this funding? How are these learner outcomes assessed? What does your latest assessment show for these learner outcomes? Submission of request--Deadline Please mail this request, along with your assessment plan to Dr. Ashlie Jack, Box 13. Call x3589 with questions. Requests are due by March 1 for funds requested during the academic year. Funding Process You will receive notice of approval. Funds will generally be transferred after invoices are received. Funds must be expended in the current academic year for which they are requested. You should submit your invoices no later than June 1. Selection priority In addition to consideration of the nature of the request, allocations are made on a first come, first serve basis. 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