Activism Grant Form

To inspire conservative students and promote activism on American college campuses, the Campus Leadership Program, presented by the Leadership Institute is offering activism grants. Groups can enter to win a grant for activism projects held throughout this semester. Please complete the application to be considered for an activism grant.

Student Information

Name Graduation Date

School Address Phone Number

Email Address

Position within hosting organization

Organization Information

Name of Organization

College/University Size of Student Body

Organization Mailing Address

City Zipcode State

Organization Phone Number Organization Email

Faculty Advisor Position of Advisor

Number of Members in Organization Conservative Publication on Campus? Yes No

Are there any other conservative organizations on campus? Yes No If yes, what are they?

Is your group affiliated with or does it receive funds from any outside organizations? Yes No

If yes, which ones?

Event Information

Event Type Date of Event:

Purpose of Event

Attendance Goal

Is this a partisan event? Yes No Does your organization engage in partisan activity? Yes No

How do you plan to promote this event? Please e-mail any flyers, handouts, or materials you will be using.

Will you promote the Leadership Institute at your event and how?

Is your event officially sponsored by your school? Yes No

Did your school provide funding? Yes No If so, how much?

Amount requested $

*All event requests must include a line item budget detailing how requested funds would be spent*

Ensure your budget is saved as a pdf, Word document, or Excel spreadsheet.

Upload Your Budget here:

Event Report

After the event, you must submit pictures, video (if possible), and a report providing details of your activism project. Your report should include the following information:

A detailed overview of the event.
The number of people who participated in your event.
Was there any opposition from other students, campus police, or faculty? How did you respond?
What did your group do to earn media coverage? Were your efforts successful? (If so, please provide links to articles / video. Mail in newspaper clippings from any coverage)
What did you learn from this event? What would you do differently next time?
Did your event result in the recruitment of new members to your organization?

I have read, understand, and agree to adhere to conditions for the grant listed above. With my signature below, I indicate that I am authorized to submit this application on behalf of the organization listed above. The information provided in and with this application is accurate to the best of my knowledge. I also attest that this event will not in any way be produced or affiliated with any partisan organization, nor will it be used to support, endorse, or oppose candidates or proposed legislation. I understand that all videos and pictures submitted to qualify for the grant may be used by the Leadership Institute to promote its programs. Funds may not be disbursed until all required documents are received.

The Leadership Institute is a non-partisan educational organization approved by the Internal Revenue Service as a public foundation operating under Section 501(c)(3) of the Internal Revenue code. The Leadership Institute does not endorse, support, or oppose candidates or proposed legislation. The Institute has an open admissions policy; all programs are open to the public. Contributions to the Leadership Institute by individuals, corporations, and foundations are tax deductible