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Event Proposal
Request Date
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Month
-
Day
Year
Date
1. Chapter+Requestor Information
SOMOSLOUD Chapter
*
Please Select
Bay Area
Buenos Aires
Central Florida
Chicago
Cuidad Mexico
Dallas
Houston
Iquitos
Lima
Los Angeles
New York
Piura
Puerto Rico
San Diego
South Florida
Tijuana
Veracruz
United Board
New
Chapter Approver
Please Select
Monica Puente + Joe Cisneros-Romo
Jonatan Gioia
USA Chapters = Monica | LATAM Chapters = Jonatan
Region
LATAM
Domestic
United Board
Chapter Point of Contact
*
First + Last Name
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
2. Event Information
Emergency Request
Yes
No
Event Name
*
Event Start Date + Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Event End Date + Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Event Address
Anticipated Attendees
*
Event Type
*
Sponsorship
SOMOSLOUD Led Event
Event Collaboration or Partnership
AHF National Event or Campaign
SOMOSLOUD International Event or Campaign
Volunteer Appreciation
Other (meeting, travel)
Relevant Framework
*
Latine Identity
Social Determinants of Health
Humanitarian Aide
Flyer Needed?
*
Yes - need flyer created
In Progress - Chapter officer to produce
No - already have one
N/A (e.g. meeting, travel, etc.)
3. Event Details
Event Justification & Goals
Brief Description/Event Summary
*
Enter a very short description of the overall event, activation, or sponsorship.
0/0
ROI Pillars
*
AHF Business Lines
Education & Prevention
Advocacy
Anticipated ROI Type + Goals
*
Advocacy/Branding/ Outreach - # of attendees
Advocacy - 340B/ PBM petition letters or vouchers
Advocacy - # of Other surveys
H&W - Testing (HIV and/or STI)
H&W - # of PrEP initiations
H&W - # of condoms
Marketing - Social Media Growth
Events - Collaborations w/ AHF Business lines
Outreach - # of new SOMOSLOUD members
Outreach - Partnerships
Other
# of Petitions Goal
*
# of Survey Goal
*
# of Condom Distribution Goal
*
# of Testing Goal
*
HIV tests
# of PrEP Initiations Goal
# of Recruiment Goal
*
If "Other", please explain
*
Event Goal ROI
*
What is the goal Return-on-Investment (ROI)? Please be as descriptive as possible and specify any of the ROI type mentioned above
0/0
Event Strategies
Social Media + Marketing Strategy
*
Current Total Social Media Followers
*
Goal # of New Social Media Followers
*
Projected new followers
Goal Total Social Media Followers
Community Engagement + Outreach Strategy
*
4. Budget Breakdown
*Please list all expenditures in U.S. Dollars*
AHF AP Vendor Processing Expenditures
A. Vendors Needed?
*
Yes
No
List of Vendor Expenditures
*
Service/Item(s) Rendered
Amount (USD)
Vendor#1
Vendor#2
Vendor#3
Vendor#4
Vendor#5
Vendor#6
Vendor#7
Vendor#8
Vendor#9
Vendor#10
Vendor#11
Vendor#12
Vendor#13
Vendor#14
Vendor#15
HIDE - List of Expenditures
Organizational Event Vendor(s) Subtotal (GL 446206)
Subtotal for all previous vendor services listed (1-15)
B. Sponsorship Payment Needed?
*
Yes
No
Sponsorship Vendor(s) (GL 441103)
*
All sponsorship vendors require a sponsorship letter or deck which outline all deliverables
Total for Vendors
All vendors NEED to be processed by AP (i.e. vendor packet, invoice, contract, etc)
AHF HR Travel Processing Expenditures
B. Travel Needed?
*
Yes
No
How Many Travelers?
*
Name of Travelers
*
Airfare (GL 446306)
Max $750
Lodging (GL 446309)
Max $250/night
Ground (GL 446310)
Travel Meals (GL 446307)
Total for Travel
SOMOSLOUD Collateral Processing
c. Advertising Collateral or Swag needed?
*
Yes
No
Other - Using Existing Swag
SOMOSLOUD Swag Order/ LOUD Fullfillment Center
Existing Swag Value
*
NOTE: This DOES NOT go into proposed budget as item is prepaid
Custom/Outsourced Swag
For swag not available via the LOUD Swag Order Form
Total for Advertising Premiums & Swag (GL 446106)
PEX Card Usage
D. PEX Card Needed?
*
Yes
No
Food / Snacks (GL 446305)
Non-Swag Incentives (GL 446205)
(i.e. raffle tickets)
Decorations/Event Supplies (GL 446403)
Miscellaneous / Other Cost
Total for PEX Card Usage
Proposed Budget
Auto-calculated depending on "Yes" or "No" question fields above
In-kind Contributions
Provided by other agencies; does not deduct from your Chapter's yearly budget and should not go into the proposed budget total.
5. Disclosure of Potential Conflict of Interest
Are any SOMOSLOUD member(s), board members, officers, or related parties associated with this request receiving—or expected to receive—any financial benefit, compensation, or other material interest related to this event or its vendors?
*
N/A - I have no conflict of interest to report
Yes - Please disclose the relationship(s) and nature of the interest below
NOTE: This includes, but is not limited to:
Serving as a board member, officer, employee, contractor, or advisor of another organization submitting a request or providing services.
Immediate family members or close associates serving on boards or in leadership roles of organizations involved.
Ownership, financial interest, or decision-making authority in any vendor, partner organization, or subcontractor.
Name(s) of SOMOSLOUD member(s) and relevant role(s)/affiliation(s)
*
please specify other nonprofit and for-profit boards you (and your spouse) sit on, any for-profit businesses for which you or an immediate family member are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own
Statements of Acknowledgement & Agreement
*
In accordance with the SOMOSLOUD Bylaws, I can confirm that this/these individual(s) did not take any part in the Chapter voting process for their final rate and vendor selection process.
I hereby certify that the information set forth above is true and complete to the best of my knowledge.
COI Disclosure Agreement
*
Links (URLs, Large Files)
Documents
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Please attach any relevant and supporting documents that are require for any services needed, including but not limited to: sponsorship letters, quotes, swag order form, and travel request form.
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