Associated Students of Michigan State University

Student Research Application

Associated Students of Michigan State University

Fall 2015 – Spring 2016

APPLICATIONS MUST BE TYPED

* Please read the instruction packet before filling out this application*

Personal Information

Name:______

Address: ______

______Telephone: ______E-mail:______

College: ______Department: ______Graduation Date:______

Research Interest Information

Research Mentor, Advisor or Major Professor:______

Email:______

Semester of Event (circle One):Fall 2015Spring 2016

Date of Conference/ Event :______

Amount Requested: (Min $100 - Max. $300):______

Please give a detailed description of the conference and what is your purpose in attending.

CONFERENCE/ TRIP

Name of Conference:Location:

Date:Number Attending:

How were attendees selected:

Project Costs and Financial Information

HOSPITALITY

Quantity / Cost Each / Total Cost / Item Info
Travel Type:
Lodging
Registration Fees
Other:

HOSPITALITY Total = $______

OTHER EXPENSES *Note only presentation materials should be listed

Quantity / Cost Each / Total Cost / Item Info

OTHER Total =_ $______

TOTAL PROJECT COST = $______

TOTAL AMOUNT REQUESTED

FROM STUDENT ALLOCATION BOARD =$______

Alternate Revenue

Other than through the Student Allocations Board, what other sources of funding have been sought for this project?

How much has been received? PLEASE BE SPECIFIC

If there are any changes to this application,

please contact the ASMSU Vice President for Student Allocations prior to the meeting.

I, the undersigned, affirm the following:

1. That the information submitted in this application and in any supporting documents is true, correct, and complete.
2. That I have read and I understand the attached guidelines and instructions.
3. That withholding or falsification of information for the purpose of receiving a funding Board allocation may result in the future ineligibility of my group for funding.
4. It is understood that the Applicant will, at his/her own expense, protect and hold harmless ASMSU, it officers, member, employees, and agents from all claims, damages, costs. Lawsuits, and expense, including but not limited to. All costs arising from administrative proceeding, court costs, and attorney fees that ASMSU may incur as a result of any act, omission, or negligence of the Applicant or any of it officer, members, employees, agents, subcontractors, or independent contractors which may arise out of this funding request.
5. The liability, if any, of ASMSU, it officers, members, employees, and agents with regard to the funding of the Applicant for any claims, costs, damages, losses, and expenses for which they are or maybe legally liable, whether arising in negligence or tort, contract, or otherwise, shall not exceed the amount of funding provided by ASMSU. In no event shall ASMSU, its officers, members, employees, and agents be liable for indirect, special or consequential damages.
6. The Applicant shall not transfer any right or interest in this request without the prior written consent of ASMSU.
7. The Applicant agrees to abide by all applicable federal, state, and local laws and ordinances, as well as all student rights and regulations set forth by Michigan State University.

______ / ______ / ______
Name / Date / Signature

A hard copy of applications should be turned into the ASMSU Business office, Located at 307 Student Services, and an electronic copy should be emailed to

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