Iowa State University
Vice President for Diversity and Inclusion
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Women’s and Diversity Grant Program
Application
Instructions:
Complete application form below.
Submit application form electronically to Karen Macdonald () by March 1. The application and supporting documents must be emailed as a single pdf file containing the following materials in order:
1) signed application form, up to four pages
2) detailed budget
3) 2-page CV or resume
For questions about a grant purpose contact Vice President for Diversity and Inclusion, Reg Stewart (). If you have questions about the application process, please contact Karen Macdonald ().
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Initiative/Project Title:
Name of Applicant(s):
Department, Program, and/or Student Organization:
Campus Address:
Telephone: Email:
Amount of funding requested:
Type of funding requested: ______One-time Project ______Seed Funding*
*If requesting seed funding, please describe how program will be funded in the future
1. Abstract /summary of the proposal
2. Body of the proposal
a. Provide introduction and/or statement of problem
b. List objectives
c. Describe the proposed initiative and address the criteria listed in the guidelines.
d. Describe how the results/outcomes will be evaluated
3. Give the timeline for implementation of the initiative (include expenditure period 7-1-2016 through 6-30-2017).
4. List other individuals/organizations collaborating on the initiative.
5. Budget: Attach to this application form a detailed budget including demonstrated financial commitment from your or other supporting departments.
6. Submit a CV or resume (up to 2 pages) for the applicant and any co-applicant. (Note: do not include CV/resume for collaborators.)
7. Agreement to take Financial Responsibility: The ISU faculty or staff member below has agreed to assume financial responsibility if this proposal is funded. This individual will be responsible for reconciling the receipts with the financial statement, processing transactions, and correcting expenses as needed.
Financial Responsibility (faculty or staff member only)
I agree to take financial responsibility for the proposed project
Signature Date
Printed Name Title
8. Endorsement of the proposed project: The chair/supervisor of each grant applicant (faculty, staff , or student organization) has agreed to endorse the proposed project.
Endorsement of Chair/Supervisor for each Applicant:
I endorse the proposed project
Applicant Name
Chair/Supervisor (signature) date
Chair/Supervisor (printed name) title
Applicant Name
Chair/Supervisor (signature) date
Chair/Supervisor (printed name) title
(Insert additional lines for signatures as needed)
12/18/15
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