Course Innovation Grant Application

OFFICE USE ONLY
File Number: / Amount Funded:
Department Number: / Date Approved:

To apply, please complete the following form. Obtain signatures, attached supporting documentation and mail or deliver to the Office of Research and Sponsored Programs – Room 208 Old Mainno later than 12 noon on Friday, April 6, 2018.Proposals that are incomplete or do not follow stated guidelines will not be reviewed.

Course Innovation Title:
Primary Author:
UWSP ID #:
Email address:
Department of Office:
College or Adm. Area:

BRIEF DESCRIPTION OF PROPOSAL: (limit to text box area)

Check ALL categories that apply to this proposal: (must be at least 0.50 FTE)

☐ Faculty☐ Academic Staff

IRB/IACUC/WEPA Approval:

☐ Not Required☐ Will Submit☐ Submitted☐ Approval Received

Credit received for course: ☐ 1☐ 2☐ 3☐ 4☐ 5☐ 6

Signatures:

______

ApplicantDate

I have received a copy of this proposal and anticipate no problems of a fiscal or personnel nature should this proposal be funded. Based on the number of eligible faculty, our dept./disciplinary unit is submitting ☐ 1 ☐ 2 ☐ 3 grant applications. (See guideline for limits)

______

Dept. Chair or DirectorDate

Course Innovation Co-Authors(please duplicate page as necessary)

Co-Author:
UWSP ID #:
Email address:
Department of Office:
College or Adm. Area:
Signature:
Co-Author:
UWSP ID #:
Email address:
Department of Office:
College or Adm. Area:
Signature:
Co-Author:
UWSP ID #:
Email address:
Department of Office:
College or Adm. Area:
Signature:
Co-Author:
UWSP ID #:
Email address:
Department of Office:
College or Adm. Area:
Signature:

NARRATIVE

The Narrative, excluding Supporting Documents, is limited to 5 pages. Page size 8-1/2 X 11; margins 1 inch on each side; font must be in Arial, Times New Roman, or Calibri type size 11 point; single-spaced. Please review Course Innovation guidelines for required information.

PROJECT SYNOPSIS:

Please insert project synopsis here based on CI guidelines.

RATIONALE:

Please list rationale here based on CI guidelines.

COURSE DESCRIPTION:

Please insert course description here based on CI guidelines.

OBJECTIVES:

Please insert learning objectives and outcomes here based on CI guidelines.

PROJECT EVALUATION & DISSEMINATION:

Please insert evaluation & dissemination plans here based on CI guidelines.

LITERATURE CITED:


VITA Summary (limit – two pages)

Name:
Department:
Rank or Title:
Date Hired:
Highest Academic Degree:
Date Awarded:

BRIEF RESUME

Please insert response here and delete the instructions in this box from the final version of your application.
Please focus on professional experience which will give evidence to the reader of your ability to undertake the intended project. List related publications, exhibits, and performances in the past five years. (Please, do not send a complete resume. Focus only on details pertinent to this project.)

LIST PREVIOUSLY AWARDED GRANTS OF ANY TYPE (external or internal) IN THE PAST FIVE YEARS.

Please insert response here and delete the instructions in this box from the final version of your application.
For past UPDC grants, state the title of the grant, date it was awarded, and summary of results (see General Guidelines).

SUPPORTING DOCUMENTS:

Letter of Support – Applicants are required to include a letter of support from their respective Department Chair, Discipline Coordinator, or in the case where the applicant is the Dept. Chair or Discipline Coordinator, a letter of support from the College Dean is required.

Additionally, the applicant must provide copies of correspondence from the college Information Technology support person and the information security person in regards to software, technology, or other needed additional support related to the proposal.

Final Report:

A report detailing the accomplishment of the objective(s) shall be submitted to the Office of Research and Sponsored Programs no later than 90 days after the project period end date. UPDC awardees who do not submit the required final report are ineligible for future awards until the report has been submitted.

The final report alone does not satisfy project evaluation and dissemination requirements as stipulated in part 7 on the Narrative instructions.

UPDC Course Innovation Summer Stipend & Required Match

Name of Applicant:
Project Title:
Project Period:
Dates of previous UPDC salary award(s) (if any):
UPDC/CI Summer Stipend: / $1,500.00

OTHER SOURCES AND AMOUNTS OF SALARY ANTICIPATED DURING THE AWARD PERIOD:

Please provide response in this area and remove instructions in your final version.

NOTE: REQUIRED DEPARTMENT MATCH ($150)

______

Signature

I have reviewed this proposal and am willing to provide $150 match.

Department (account) number:

______

Dept. Chair or DirectorDate

GRANT APPLICATION CHECK-OFF SHEET

The grant application should include the following sections in order. This form is provided to insure completeness of the grant application. DO NOT INCLUDE IT WITH THE APPLICATION AT THE TIME OF SUBMISSION.

☐Cover sheet completed and signed by the applicant(s) and Department Chair(s).

☐Proposal narrative completed according to guidelines.

☐Project Synopsis

☐Rationale

☐Course Description

☐Learning Objectives/Outcomes

☐Project Evaluation & Dissemination

☐Literature Cited

☐VITA summary completed including a list of previous grants received. (limit 2 pages)

☐Summer salary and match approvalcompleted.

☐ Letters of Support from Dept. Chair/Discipline Coordinator or Dean if required.

*OTHER (limited to 5 pages)

☐ IRB approval: Prior to beginning any research involving human subjects at UWSP, or any other location, you must be approved or certified by the University’s Institutional Review Board (IRB) for the Protection of Human Subjects. This includes any human subject research at other locations, if being funded by UPDC. See Appendix A in the Guidelines for details.

☐ IACUC approval: Prior to beginning any research involving animal experimentation at UWSP, or any other location, you must be approved or certified by the University’s Institutional Animal Care and Use Committee (IACUC). This includes any animal experimentation research at other locations, if being funded by UPDC. See Appendix A in the Guidelines for details.

☐ If required, certification for environmental impact (WEPA). See Appendix A in the Guidelines for details.

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