Office of Undergraduate Research
Undergraduate Research Grant Proposal Cover Sheet
Application Date:______________________________________________________________________________________________
Project Title: ___________________________________________________________________________________________________
Student Name: ____________________________________________ Vandal Number: ________________________________
Address: _________________________________________________________________________________________________________
Phone Number(s): __________________________________ e-mail address: ______________________________________
Degree Program: ______________________________________________ Major: _______________________________________
Research Integrity and Compliance:
a) Proposal constitutes original work Yes No
Will your work involve any of the following?
b) Research on Human Subjects Yes No IRB#_________________
c) The use of Vertebrates (animals) Yes No IACUC#______________
d) Use of Radiation, Chemical Hazards, or Lasers Yes No
e) Use of Biohazards (Infectious Agents, Recombinant DNA) Yes No
f) Conflicts of Interest Yes No
g) Intellectual Property / Technology Transfer Yes No
h) Import or Export of Data, Goods or Services Yes No
i) Classified Information / Collaborative Research Yes No
If yes, please explain: _________________________________________________________________________________________
Student’s Signature*: _________________________________________________________________________________________
Sponsoring Faculty Mentor ____________________________________ Department/College ___________________
Is this project receiving funding from another source(s)? Yes No
If yes, please explain: _________________________________________________________________________________________
Are you doing this work in conjunction with a faculty member’s work? Yes No
If yes, please explain: _________________________________________________________________________________________
I certify that I have reviewed this student’s proposal, that this student is capable of performing the work
described, and that I will mentor the student throughout this project.
Faculty Signature*: ____________________________________________________________________________________________
*Cover sheet must be signed by student and faculty mentor
Submit by posted deadline to the Office of Undergraduate Research at
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