CAMPUS ALIVE APPLICATION

Name of Pro-Life Club

Name of College or University

Name of Advisor

First Name

Last Name

Advisor's Email

Name of Individual Completing the Form

First Name

Last Name

Cell Phone Number

Please describe the mission of your pro-life club in a few sentences.

Please describe your pro-life club need/request in a few sentences.

Please Select Are of Need:

Funding

Resources

Mentoring

If you selected funding, please indicate amount ($) and date needed by.

What is the timeline for accomplishing the project/event?

Is your pro-life club 100% pro-life with no abortion exceptions?

Yes

Where does the pro-life club stand on embryonic stem cell research and contraception?

How will this project/activity/event benefit the student body on your campus?

How will you get more students involved in this project/activity/event?

Will you be seeking any other funding for this project/activity/event? If so, please list your other intended benefactors.

Please provide the name and email address of the person handling the marketing and advertising of the event. If funds are granted for your project, Pro-Life Wisconsin, as a sponsor, requessts recognition throughout the promotion and execution of your project/activity/event.