ࡱ> g bjbjJJ 4(ub(ubhhhhh||||H|0'4"  &&&&&&&$)+&hhhh&hh&"""hhh&"h&""3%%PT0U~K%&'00'S%,,,%,h%0I""k&&: t0'hhhh,B .: SCHUPF SCHOLAR (10 Week Grant Period) APPLICATION COVER PAGE Please attach this page to all materials submitted. SUMMER 2022 DEADLINE: Friday, January 28, 2022 SEE: Schupf Scholar Program Application Guidelines.  HYPERLINK "http://www.skidmore.edu/fdc/schupf/schupf-scholar-program.php" http://www.skidmore.edu/fdc/schupf/schupf-scholar-program.php 1A. Faculty Name: Click here to enter text.Department:Click here to enter text.E-Mail Address: Click here to enter text.Title:Click here to enter text.Faculty Status:  FORMCHECKBOX  Tenured  FORMCHECKBOX  Tenure-track  FORMCHECKBOX  Non-Tenure  FORMCHECKBOX  Full-Time/Regular  FORMCHECKBOX  Full-Time/Temporary  FORMCHECKBOX  Other: Click here to enter text.Faculty Prior Participation in Summer Research Program?  FORMCHECKBOX  No  FORMCHECKBOX  Yes When? Click here to enter text.1B. Student Name: Click here to enter text.Class Year:Click here to enter text.Student E-Mail Address: Click here to enter text.PO Box:Click here to enter text.Student Prior Participation in Summer Research Program?  FORMCHECKBOX  No  FORMCHECKBOX  Yes - When? 2. Title of Project: Click here to enter text.3. Description: Provide a statement of 500 words or less describing the proposed project in language understandable to the non-specialist. The Faculty Development Committee membership includes faculty from different disciplines. It is your responsibility to provide a description of your project and your objectives that is easily understood by someone outside your area of expertise. Attached?  FORMCHECKBOX  Yes  FORMCHECKBOX  No 4. Statement written by the faculty providing a description of the working relationship with the student and how the experience benefits the student's educational, professional, and/or creative goals. Attached?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Signed?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Do you have external funding to support this project during the summer?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If so, how much and for what period? Click here to enter text.5. Statement written by the student providing a description of the working relationship with the faculty member and how the experience benefits his/her educational, professional, and/or creative goals. Attached?  FORMCHECKBOX  Yes  FORMCHECKBOX No Signed?  FORMCHECKBOX  Yes  FORMCHECKBOX No6. Goals, proposed activities, and format of final outcome expected: Provide information as to what you intend to accomplish during the research period and the format of the expected final outcome; e.g., journal article, presentation at a conference, exhibit, website, performance, etc. Attached?  FORMCHECKBOX  No  FORMCHECKBOX  Yes7. Budget: Provide an itemized budget indicating the cost of equipment and supplies needed to complete the project. Expenditures must be in support of the project goals and are not intended for entertainment purposes. Attached?  FORMCHECKBOX  Yes  FORMCHECKBOX  No  8. IRB: Does this proposal involve human subjects or the use of human tissues that are subject to the requirements of the Colleges Institutional Review Board (IRB)?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If yes, you must obtain IRB approval prior to the commencement of the research. IRB guidelines, FAQs, and forms are available at:  HYPERLINK "http://www.skidmore.edu/irb" http://www.skidmore.edu/irb. IACUC: Does this proposal involve the use of vertebrate animals that are subject to the requirements of the Colleges Institutional Animal Care and Use Committee (IACUC)?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If yes, you must obtain IACUC approval prior to the commencement of the research. IACUC guidelines and forms are available by contacting the IACUC Chair. 9. Signatures and dates. Your signature indicates that you have read and understood the program goals, application procedures, criteria for selection, and general information and that you accept all the responsibilities inherent therein. Both faculty and student participant must sign this application before submitting it to the Office of the Dean of the Faculty and Vice President for Academic Affairs. _________________________________________________ Date: ___________________________ Faculty Members Signature _________________________________________________ Date: ___________________________ Students Signature PLEASE NOTE: A FINAL REPORT must be submitted to the Office of the Dean of the Faculty and Vice President for Academic Affairs by May 15 of the year following the summer research period. Faculty members must submit one report for each award. Failure to file a final report may result in advances being treated as taxable income and will disqualify participants from future grant opportunities. The Final Report, submitted online, will consist of: A written summary and a brief description of expenditures. A description of the future educational and professional plans of the student participant, including plans for additional research in their junior and senior years. The final report forms can be found at: FACULTY Final Report:  HYPERLINK "http://www.skidmore.edu/fdc/schupf/schupf-scholar-program-faculty-final-report.php" http://www.skidmore.edu/fdc/schupf/schupf-scholar-program-faculty-final-report.php STUDENT Final Report:  HYPERLINK "http://www.skidmore.edu/fdc/schupf/schupf-scholar-program-student-final-report.php" http://www.skidmore.edu/fdc/schupf/schupf-scholar-program-student-final-report.php All materials and/or equipment purchased with grant funding become the property of С College upon completion of the project. The applications which are funded may be placed in a file accessible to the public, foundations, media, and future applicants. 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