Stipend Request Form

Request funds from CU to support your work.

We are excited to support you in bringing more civic activity to your community! We know it takes time and resources, and we want to minimize barriers between you and creating meaningful experiences with your community.

This form will ask you for details about your expenses.

What's your name?(Required)

First Last

What's your email?(Required)

Select an option to show more fields.(Required)

Homecoming Travel Stipends

What was the cost of your purchased travel?(Required)

How much stipend money are you requesting?(Required)

Please only request what you really need to make this possible. For example, if your flights were $300, but you can only afford to pay $150, please only request the remaining $150. By requesting only what you need, you're ensuring there are funds to support catalysts who would otherwise be unable to be a part of the special experience that is Homecoming!

Upload your receipts.(Required)

Drop files here or

Max. file size: 31 MB.

Please share photos or PDFs of your receipts.

Who should we make a check out to?(Required)

Where should we mail a check?(Required)

Street Address Address Line 2 City State Zip

Finally, do we have a W9 on file for you?(Required)

Yes! I've either submitted one before, or I've completed the DocuSign link in this question's description just now.

No, but I have one I can attach to this form.

To be in compliance with IRS regulations, we need a W9 on file to complete your stipend request. If you'd like to complete one via DocuSign, you can do that here.

Please upload your W9 here(Required)

Max. file size: 31 MB.

One final note, if you'd like to receive your stipend via direct deposit to your bank account instead of a mailed check, you can complete the authorization form here.

Local Civic Collaboratory Stipends

We are excited to help catalyze your local civic collaboratory gatherings and remove cost barriers as we're able. You'll receive the funds by either check or direct deposit, in line with the preference you shared with us.

What is your organization?(Required)

How much are you requesting?(Required)

Please describe how you plan to use these funds.(Required)

As a Collaboratory convener, you have access to up to $2,000 to cover costs associated with hosting your Collaboratory. You can request these funds all at once, or as needs arise. Funds must be used by June 30, 2024.

By receiving this stipend, I agree to only use these funds for to support our local civic collaboratory gatherings, and the purposes specified in this request.(Required)

I agree.

Due to legal requirements of our funding and tax status, by receiving a stipend from Citizen University, you affirm that these funds will be used to further CU’s charitable purpose and will not be spent on activity that supports or seeks to influence the outcome of any public election or campaign; or otherwise attempts to influence legislation; or carries out a voter registration drive.

Anything else you'd like us to know?

Civic Saturday Gathering Stipends

We are excited to help catalyze your Civic Saturday gatherings and remove cost barriers as we're able. If your expenses cross multiple gatherings, please submit a separate form entry for each gathering.

Are you using this stipend for anticipated expenses — or to be reimbursed for what you've spent?(Required)

This for anticipated expenses.

This is to be reimbursed.

How much are you requesting?(Required)

You have access of stipends up to $300 each time you host to cover expenses for things like refreshments, space rental, compensating working musicians or poets, audio/visual equipment rental, copying/printing materials, etc.

What is the date of your gathering?(Required)

MM slash DD slash YYYY

By receiving this stipend, I agree to only use these funds for my Civic Saturday gathering, and the purposes specified in this request.(Required)

I agree.

Please provide a detailed description of anticipated expenses.(Required)

List out the expenses and how you'll be using the funds.

Please provide a description of your expenses.(Required)

List out the expenses and how you'll be using the funds.

Upload your receipts.

Drop files here or

Max. file size: 31 MB.

Please share photos or PDFs of your receipts.

Who should we make a check out to?(Required)

Where should we mail a check?(Required)

Street Address Address Line 2 City State Zip

Anything else you’d like us to know?

Finally, do we have a W9 on file for you?

Yes! I've either submitted one before, or I've completed the DocuSign link in this question's description just now.

No, but I have one I can attach to this form.

To be in compliance with IRS regulations, we need a W9 on file to complete your stipend request. If you'd like to complete one via DocuSign, you can do that here.

Please upload your W9 here

Max. file size: 31 MB.

One final note, if you'd like to receive your stipend via direct deposit to your bank account instead of a mailed check, you can complete the authorization form here.

Stipends for Op-Eds

We are excited to help catalyze more storytelling and narrative change through op-eds! You are eligible to receive a $300 if you write and pitch an op-ed in line with the 'stories of connection across difference' campaign.

What's the status of your op-ed?

I am still working on finalizing my draft.

I have written it and shared it with CU team-member, Natalie Valentine.

It has been published by a newspaper or media outlet!

Ok! When do you anticipate completing your draft? Please share some details here and we'll follow up with you.

Amazing! Please share a link to the story here so we can see and celebrate your efforts.

Who should we make a check out to?(Required)

Where should we mail a check?(Required)

Street Address Address Line 2 City State Zip

Anything else you’d like us to know?

Finally, do we have a W9 on file for you?

Yes! I've either submitted one before, or I've completed the DocuSign link in this question's description just now.

No, but I have one I can attach to this form.

To be in compliance with IRS regulations, we need a W9 on file to complete your stipend request. If you'd like to complete one via DocuSign, you can do that here.

Please upload your W9 here

Max. file size: 31 MB.

One final note, if you'd like to receive your stipend via direct deposit to your bank account instead of a mailed check, you can complete the authorization form here.

By receiving this stipend, I agree to only use these funds only to support my time writing and publishing an op-ed in line with the guidelines.(Required)

I agree.

This field is for validation purposes and should be left unchanged.

Stipend Request Form

Homecoming Travel Stipends

Local Civic Collaboratory Stipends

Civic Saturday Gathering Stipends

Stipends for Op-Eds

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