Application for Non-Senate Faculty Professional Development Grant
Applications are to be submitted as .doc, .docx or pdf documents, with a scanned signature page – see instructions below.*
Date of application:
Name of Applicant:
Grant Title:(e.g. “Mary Smith’s 2016 Canadian Biometrics Conference Travel Grant”)
Dollar Amount Requested: $
(Please state the fund amount being requested, even if the budget may be higher for other reasons. If your request is less than $750.00, this request will be treated as a small grant application and will be submitted for ongoing review. If your request is for $750.00 or more, then the request will be treated as a large grant request that is to be considered in the grant review meeting of the NSF PDF committee.)
Department/Program/College:
On-campus Mailing Address:
email address: daytime phone:
Status of your NSF employment: Continuing (“post-six”) Pre-six
Dates on which funds have been or will be spent:
I. Project Description
Please provide a brief description of your project (300 words maximum):
II.Statement of Pedagogical Relevance:
Briefly explain how this project relates to your teaching, curricula, and/or other NSF duties (200 words maximum):
III.Budget:
Attach a tabulated budget of your expenses here or as an attachment: (see the NSF PDF Guidelines for information on how to configure your budget). Please submit the file as a pdf, .doc or .docx with the file name FirstinitialLastnameBudget (e.g. MJonesBudget.docx)
IV.Written Confirmation of an NSF appointment:
Because the PDF is intended to support the professional development of UCSC NSF, applications from pre-six NSF must include written confirmation from the dean of a future NSF appointment/reappointment if the funding is to be used in a quarter subsequent to the end date of the NSF’s current appointment. There is no requirement of an annual appointment or reappointment, but only that there is an NSF appointment that will follow the quarter or summer in which the award was used. Ideally, the dean’s letter would accompany the grant application. However, in the event that the appointment/reappointment letter is not available at the time the application is submitted, the administration’s approval of the grant award will be deferred until the confirmation of the future appointment/reappointment letter is received. [NSF with continuing (“post-six”) status are not required to submit any appointment confirmation.]
V.If this is a retroactive request:
If this is a retroactive request please attach copies of all appropriate receipts (retain your originals for the time being) and a completed post-travel form (if travel was involved).
VI. Equipment purchases:
Any proposal for the purchase of equipment must be supported by a statement from the NSF’s department chair or college provost, stating that the item is not available from the department or college. Equipment remains the property of the university and will be added to departmental inventory.
The following page may be scanned and sent electronically with the application (or completed with electronic signatures) to or hardcopy sent to Tony Hoffman at Psychology Faculty Services (please send only this page in hardcopy).
VII. Required Signatures:
This application must be signed by the NSF applicant and the applicant’s department/program chair or college provost. The signature of the chair or provost indicates that the applicant is in good standing, and that the statement of pedagogical relevance in section II is supported. The signature of the applicant certifies agreement with the Statement of Understanding (see below).
[The following types of electronic signatures are acceptable: 1) a jpg or jpeg signature; 2) an ink signature on a document that is submitted as a pdf via email or in hardcopy; or 3) a one-line email from the chair or provost that contains the applicant's name and confirms that the NSF is in good standing and that the NSF's Statement of Pedagogical relevance is supported.]
Grant Title: ______
Department Chair or College Provost:
Signature: ______
Date
Printed name: ______
Statement of Understanding:
If awarded a grant, I understand and agree to the following: Unit 18 Professional Development funds awarded for this project are intended for project activities only; that all materials purchased or developed with these monies become the property of the University of California; that any library materials, such as books, slides, videos, compact discs, etc., will be housed in the appropriate campus library and made available on a check out basis; that any equipment will be housed either in Media Services or the recipient’s Division; that any copyright for software or other materials developed with these funds will reside with The Regents of the University of California; that any publication, either professional or popular, resulting from project activities funded by the Unit 18 Professional Development Program will acknowledge support from the Unit 18 Council on Professional Development and the University of California, Santa Cruz.
Applicantsignature:
______
Date
Printed name: ______
VIII.Application Submission:
This application is to be submitted to as a .doc, .docx or pdf document (with the possible exception of the signature page – see instructions above). Submit your completed application to . Please submit files with names using the following names: FirstinitialLastnameSmallgrantApp, FirstinitialLastnameEmploymentStatus, FirstinitialLastnameSupplements, FirstinitialLastnameBudget, etc. (e.g. MJonesPDFgrantApp.docx, MJonesCV.pdf, MJonesReceipts, etc.).
Ifyou have questions or concerns about your application, contact the PDF Chair (Tony Hoffman) nd/or review the Non-Senate Faculty Professional Development Fund Guidelines and Policies available online at (click on, or search for, “Professional Development Grants”
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