GUIDELINES

• Scholarly and creative activity refers to original undergraduate-driven research in which the undergraduate is the principle investigator.
• Reasonable expenses may include the following types of items: travel, equipment, materials, supplies, and services.
• The WU-CSI Grant Committee will not review requests for the support of graduate work.

WU-CSI Project Support Application
WASHBURN UNIVERSITY

http://www.washburn.edu/wu-csi

NAME __________________________________________________________
Contact information:
    Address: ______________________________________________________
                     ______________________________________________________
    Phone:     ______________________________________________________
    Email:      ______________________________________________________

Overall GPA ___________

Major ________________________________

Total hours completed:
        Overall ___________
        In major ___________

NATURE OF PROPOSED PROJECT (Complete the attached form as it relates to your specific request and attach supporting data.)

Attach a description that presents the rationale of the project and its objective, along with any appropriate documentation.

Include a proposed timeline indicating start and completion dates.

Include an explicit and detailed budget (include estimated delivery/freight/postage charges).

Proposed research requires the use of human or animal research subjects: [  ] YES     [  ] NO
(NOTE funding is contingent upon the approval of the Institution Review Board)

What is the status of your project with regard to IRB approval? (Check one)

Not yet submitted _____ Approved______ (attach copy of approval)
Pending approval _____ Not Applicable_____

AMOUNT REQUESTED: $_________________ a) Have you received prior funds for THIS project from this committee? [  ] YES     [  ] NO
If yes, indicate the amount ______ and date received ______________ b) Have you applied for/or received funds for THIS project from another source? [  ] YES     [  ] NO
If yes, indicate the amount _____ and source ____________________   c) Have you received prior funds for a project from this committee? [  ] YES     [  ] NO
If yes, indicate the amount _____and date received ________________

and attach information regarding the previous project.

           d) Have you completed all of the requirements of previous grants received from the WU-CSI committee?
                   [  ] YES     [  ] NO    [  ] not applicable

If previously awarded funds from WU-CSI, the student must have fulfilled all requirements of previous awards and must be in good standing, as defined by the WU-CSI Committee.

APPROVALS
_________________________________________________   ______________
Applicant signature                                                                                     Date:
(By signing this application, you agree to submit a final presentation to the WU-CSI Grant Committee.)
_________________________________________________   _____________
Faculty Supervisor signature                                                                        Date
_________________________________________________   _____________
Department Chair signature                                                                         Date

DELIVER TO PSYCHOLOGY OFFICE (HC 211) AFTER ALL REQUIRED SIGNATURES HAVE BEEN OBTAINED.

REQUEST FOR SUPPORT OF A PROJECT

 

The submitted proposal should contain the following information:

DESCRIPTIVE TITLE

ABSTRACT (including)

Purpose

Significance

General Description of Project: (hypothesis & methodology if empirical)

LETTER OF SUPPORT

The letter should be written and signed by the faculty supervisor. This letter should also be co-signed by the Chairperson of the Department.

Potential for publication, presentation, performance or exhibit:

Where may you be able to present or perform this work?

Are equipment and/or materials being requested?

[  ] YES [  ] NO
If yes, how will they be used?

Are the requested resources currently available at Washburn University?

[  ] YES [  ] NO
If yes, rationale for this request?

Assuming your proposal has been approved, which ONE of the following do you prefer? (Check one)

_____ I plan on purchasing the requested materials myself and to then be reimbursed by the University.
_____ I prefer to have the requested materials purchased through the University.

(Note: Equipment acquired through a CSI grant becomes the property of Washburn University.)

Budget

SUMMARY OF ALL REQUESTS:
 
 
 
 
 
 
      
              
 
 
 
 
 
 
 
 

TOTAL REQUESTED: $_________________

COMMITTEE USE ONLY

Date Application Received ______________________
Email Acknowledgement of Receipt Sent ________________    Application Complete [  ]YES      [  ] NO
Approved_______________ Not Approved _______________ Approved with modification_______________

Comments _______________________________________________________________

 ______________________________________________________________________

_______________________________________  _____________________
Committee Chair signature                                                                     Date