MTSU Sustainable Campus Fee Funding Request Form

MTSU Sustainable Campus Fee Funding Request Form
The Sustainable Campus Fee (SCF) supports projects that advance sustainability at MTSU. This form allows students, faculty, and staff to propose initiatives that contribute to a greener campus through energy efficiency upgrades, infrastructure improvements, education, research, and efforts to enhance campus biodiversity. As part of the application, you will be asked to provide an estimated cost for your project. We suggest obtaining any necessary pricing information before beginning the form.

There are 5 sections to the application: Section I: Contact Information, Section II: Project Category, Section III: Project Description, Section IV: Project Cost, and Section V: Project Performance Information (For applicable projects).

You can save your application and return to it later. Just make sure to save your progress before exiting to avoid losing any information. Please note that the application deadline is September 29.

The Sustainable Campus Fee is administered through a partnership with the Office of Student Affairs, the Center for Student Involvement & Leadership, and the Center for Energy and Sustainability (CES).

If you have any questions about completing this application, feel free to contact the CES at ces@mtsu.edu. We're happy to help and provide any additional information you may need.
Date

MonthDayYear
Date
Request Number
1. Name*

First NameLast Name
Email*
Phone Number

SECTION III: Project Description
Please include as much detail as possible in this section. The more information you provide, the better equipped the adjudication committee will be to fully understand your request and make an informed decision.

To expand a text box, click and drag the two diagonal lines in the bottom-right corner. This allows you to adjust the size and view of your content as you type.
1. Project Title*
Please provide a brief descriptive title for the project.
2. Scope: Work to be accomplished*
Please give a detailed description of the work that will be accomplished for the project.
3. Scope: Benefit Statement*
List the advantages of the project as it relates to the selected project category (Energy Conservation/Efficiency, Renewable Energy, Sustainable Transportation, Alternative Fuels, Recycling, Waste Reduction, Water Conservation, Biodiversity, Education, Research and Innovation, Other)
4. Location of Project *
Name of building, department, and/or specific location of where the project will be conducted on campus.
5. Participants and Roles*
List any departments you anticipate being involved in this request. If any departments were consulted during the preparation of this request, please list them along with the names of individuals and their roles or titles.
6. Student Participation in the project and/or Student Benefit from the project*
Provide specific information on anticipated student involvement or benefit.
7. Future Operating and/or Maintenance Requirements*
Provide information for anticipated future operating and/or maintenance requirements occurring as a result of the proposed project.
8. Additional Comments or Information Pertinent to the Proposed Project
Note, all projects are expected to be completed by December 31, 2026.

SECTION IV: Project Costs
1. Project Cost Estimate*
The project cost estimate is the expected cost of the project to be considered by the committee for approval, which may differ from the total project cost in the case of matching funding opportunities. Any funding request is a 'not-to-exceed' amount. Any proposed expenditure above the requested amount will require a resubmission.
2. Source of Estimate*
List the source, vendor, methodologies, historical data, etc. used for this project cost estimate.
3. Has previous funding from this source been awarded?*

YesNoNot Sure
If Yes, please explain how this request differs from previous funding request.
Please upload any quotes, estimates, or supporting documents that may help strengthen your application.

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SECTION V: Project Performance Information

If your project is expected to reduce energy consumption (e.g. through lighting upgrades or HVAC improvements etc.), please provide an estimate of potential savings. Feel free to contact the Center for Energy and Sustainability for help making these calculations at ces@mtsu.edu.
1. Estimated Annual Energy Savings (Estimated in kW, kWh, Btu, etc.)
Provide information on estimated annual energy savings stated in units such as kW, kWh, Btu, gallons, etc.
2. Annual Energy COST Savings ($)
Provide information on estimated annual energy cost savings in dollar amounts. Basic rate for electricity is $0.095/kWh and water is $0.0092 per gallon.
3. Annual Operating Cost Savings or Other Cost Savings. Specify in dollar amount, if applicable. ($)
Provide information on any annual operating cost savings or other cost savings in dollar amounts. Be specific.
4. Matching or Supplementary Funding (Identify and explain, if applicable)
Provide information regarding any matching or supplementary funding opportunities that are available. Identify all sources and explain.

If your project is selected for funding, upon completion, you will need to submit a brief summary along with a photo of the finished project to ces@mtsu.edu.
Acknowledgment*

I acknowledge that a project summary and photo must be submitted, if I am awarded funding and upon completion of the project.
SAVE or SUBMIT

You can save this form and continue working on it later, or simply submit it now. You will receive an email with a link to return to your saved form to make changes. Once your request has been submitted, contact Kristen Hargis at kristen.hargis@mtsu.edu to make changes to your submission. Thank You!
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MTSU Sustainable Campus Fee Funding Request Form

SECTION II: Project Category

SECTION III: Project Description

SECTION IV: Project Costs

SECTION V: Project Performance Information

SAVE or SUBMIT