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St. Cloud State University
2013 MSUAASF Special Initiative Award
Cover Sheet
SECTION I. Applicant Contact Information
Name Other Contact Name
Title/Position Title/Position
Campus Address Campus Address
Phone Phone
Fax Fax
Email Email
SECTION II. Project Information
Title of the Project
Names of MSUAASF Applicants Amount of Initiative Award
Estimated No. of Hours
to be Spent on Project
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SECTION III. Budget Summary and Narrative
Please use the table below to organize your proposal’s budget information.
Budget Category Description Amount Source of Funds
Equipment (e.g. hardware
Software Purchases
G.A. or Student Employee
Certification Signatures
Based on the criteria for eligibility in the 2011-2013 MSUAASF/MnSCU agreement (Article 12, Section 1), I
certify I am eligible to apply. I understand and agree that a written final report, including how the objectives and/or
goals have been achieved, is due as stated in the guidelines. I will provide a copy of my report to the Special
Initiative Award Committee and to my supervisor. I understand that unless a law exists characterizing some portion
of the information submitted as private, proposals will be treated as public information in accordance with
University, state, and federal privacy regulations.
Applicant’s Signature Date
Supervisor’s Signature
Supervisor’s signature certifies that resources necessary to carry out the project are available and committed.
All applications must be sent to HRSIA@myscsu.stcloudstate.edu and copy
humanresources@stcloudstate.edu by Friday, October 18.
Only complete applications will be reviewed.