Fillable Renewal-surf-applicant-form - renewal application SURF

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Renewal-surf-applicant-form - renewal application SURF

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Symposium Undergraduate
Research Fellow
Renewal Request
The Symposium Undergraduate Research Fellow program is designed to provide selected students with a
unique opportunity to participate in extended research with a faculty mentor within their academic
discipline. Ultimately, all Symposium Undergraduate Research Fellows are expected to present the
outcomes of their research at the annual Undergraduate Symposium.
Fellows, when first selected, are students new to Eastern Michigan University as either incoming
freshmen or transfer students. They may request renewal of their fellow award and the opportunity to
continue their research opportunity with their same faculty mentor for up to four academic years.
Eligibility:
To apply for the renewal of a fellow award, the student must in good academic standing with the
University. The faculty mentor should hold a full-time tenured or tenure-track appointment or be a full-
time lecturer (exceptions to the latter requirement need the approval of the head of the sponsoring
department).
A Symposium Undergraduate Research Fellow award may be held concurrently with any other form or
amount of financial aid, whether based on need or merit (however, students with need-based aid are
subject to federal guidelines). The award may be terminated at any time if, in the faculty mentors’s
judgment, the student’s performance is unacceptable. Award income is considered taxable by the Internal
Revenue Service.
Instructions to the renewal applicant:
1. Complete the renewal application form.
2. Respond in essay format to the questions outlined here.
Attach your typed responses to the following on a separate sheet of paper:
• Describe the scope and results of your research during this past academic year.
• If you presented at the Undergraduate Symposium, describe from your perspective
the highlights of the experience.
• Discuss the future directions you would like to take as a fellow, either expanding your
current research topic or a new focus.
3. Request that the faculty mentor to complete a supervisory statement and commitment to
continue as the fellow’s mentor.
4. Submit by the deadline of May 1 at the close of the current academic year.
Symposium Undergraduate Research Fellow
–– Student Renewal Application ––
Renewal requested for academic year: ________________
Name: _________________________________________ Student Number: _______________
Permanent mailing address: _______________________________________________________
City/State/Zip: _________________________________________________________________
Email: ________________________________________________________________________
Phone number(s): _______________________________________________________________
Current EMU GPA: ___________ Hours completed (as of end of current semester): _________
Major(s): ___________________________________ Minor(s): __________________________
Faculty mentor: ________________________________________________________________
Department: ___________________________________________________________________
Fellow history:
Academic year Research topic Symposium presentation
(oral or poster)
If I receive an award, I agree to abide by the award guidelines. If for any reason I am unable or unwilling to fulfill the
expectations of awardees, I understand that my award may be terminated and that I may be billed for the award amount.
Signature of applicant: ___________________________________ Date: __________________
Symposium Undergraduate Research Fellow
–– Faculty Mentor Statement ––
Name of student fellow: __________________________________________________________
Department: ___________________________________________________________________
Name of faculty mentor: _________________________________________________________
Campus phone number: __________________ Email: _________________________________
Discuss the following in relationship to the Undergraduate Research Fellow and your willingness
to continue in the faculty mentor role (attach as a separate piece, if you prefer):
Detail the growth of the student fellow this past academic year.
Outline the direction of the research to be undertaken in the next academic year that supports
renewal of the fellow appointment for the student.
************************************
I support the reappointment of _________________________ (student name) as a Symposium
Undergraduate Research Fellow for the academic year _____________. I am willing to continue
to serve as the faculty mentor and to provide the guidance to advance the academic research
proposed.
Faculty mentor signature: _________________________________ Date: __________________
************************************
As department head, I support the continuation of this fellow appointment. Comment: ________
Department head signature: ________________________________ Date: __________________
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Completed 12 February 2020

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