Fillable Chapter 606 Research Application - Chapter 606 Research Application

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Chapter 606 Research Application - Chapter 606 Research Application

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Office&Use&Only&
&
Date&Recd.________&
&
Amt.&Recd.______&
&
Req.&No.&&&______&&
&
APPLICATION)FOR)CHAPTER)606)RESEARCH)FUNDING)
&
Please&submit&application&with&signatures.&&Submit&application&no&later&than&(7)&days&prior&to&the&meeting.&
&
Name:&__________ _ __ _ _ _ _ __ _ ______________________________________&&
Date:&____________ _ _ _ __ _ _ _ _ __ _ _ _ _ __ _ _____________________________ &
Campus&Mailing&Address:&______________ _ _ __ _ _ _ _ __ _ _ _ _ __ _ _ _ _ __ _ _ _ _ __ _&
Classification:&Freshman&___Sophomore&___Junior&___Senior&___Other&___&
&
List&Any&Other&Previous&Deg re e s &or &C e rtific a te s &H e ld :&
________________________________________________________________
________________________________________________________________&
&
Faculty&Research&Advisor:&___________________________________________&
&
Faculty&Phone:&____________________________________________________&
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Date&That&Project&Will&Begin:&_________________________________________&
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Anticipated&Date&of&Completion:&______________________________________&
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Amount&of&Funds&Needed&for&Project:&__________________________________&
&
Amount&of&Funds&Requested&from&Chapter&606:&__________________________&
&
Total&Amount&of&Funds&Available&from&Other&Sources:&_____________________&
&
Itemized&Proje ctio n &o f&T o tal&E x p e n ditu r es :&______________________________&
&
&
&
________________________________________________________________&
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Itemized&Proje ctio n &o f&E x pe n d itu re &o f&C h a p ter &6 06 &F u n d s:&__________________&
&
________________________________________________________________&
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________________________________________________________________&
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Detailed&Description&of&Proposed&Project:&______________________________&
&
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________________________________________________________________&
&
How&Do&You&Intend&to&Publish&Your&Conclusions?&________________________&
&
&________________________________________________________________&
&
________________________________________________________________
&
&
&
We&agree&that:& & 1.&&Any&funds&allotted&will&be&used&solely&for&the&purpose&
stated.&
&
2.&&You&will&be&responsible&for&filing&a&“Conclusion&of&
Research&Report”&with&the&committee&following&the&even t&
or&purchase,&and&&
&
3.&&Everything&stated&above&is&true.&
&
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_________________________& & & ___________________________&
&&&&&&Faculty&Advisor& & &&&&&&&& & & & & Student&
&& (Original&signatures&are&required)&
&
&
& ATTACH&ANY&ADDITIONAL&INFORMATION&
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Chapter 606 Research Application - Chapter 606 Research Application

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Completed 18 March 2020

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