The Center for
Experiential Learning
Social Justice Research Fellowship Research Budget Request
Please fill out and submit this form to to access your research budget. Depending on method of payment, be sure to include any receipts for reimbursement (scanned copies accepted) or completed purchase order forms.
Provost Fellow __________________________ Mentor ____________________________
_____ Summer 2014 Fellow
_____ Academic Year 2014-2015 Fellow
Explain briefly what this reimbursement or purchase request is for and include total amount. If submitting receipts, please indicate who is to be reimbursed. If submitting more than 2 receipts, please include an itemized list.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I understand that this research budget request will be taken from my Provost Fellowship budget, which is limited to the amount stated in my award letter, and can be spent only on research supplies or research-based travel. (You may print your name and send this form electronically via LUC.edu emails to serve as an electronic signature).
_______________________________________ ______________________________
Signature of Provost Fellow Date
AND
_______________________________________ ______________________________
Signature of Faculty Mentor Date
After completing this form, please email it to .
Learn. Serve. Experience. Transform.
Center for Experiential Learning
773 – 508 – 3366
www.luc.edu/experiential