Undergraduate Research and Travel Grants Program
Research Grant Application
Applicant Information:
Full Name: / Click here to enter text. / Major: / Click here to enter text.Phone: / Click here to enter text. / UWPlatt Email: / Click here to enter text.
Alternate Email: / Click here to enter text.
Class Standing: / Choose an item. / Gender:(Optional) / Choose an item.
Cum. GPA: / Click here to enter text. / Race/Ethnicity:
(Optional) / Click here to enter text.
I am a member/active participant in the following groups/organizations (check all that apply).
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☐ STEM Scholars
☐ DRIVEN Scholars
☐ Cooper Scholars
☐ WiSTEM LLC
☐ WEMS Mentor Program
☐ Society of Women Engineers
☐ Math Learning Center Tutors
☐ Other (please specify): Click here to enter text.
☐ None
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Project Information:
Research Project Title: Click here to enter text.
Faculty Research Advisor Name: Click here to enter text.
Please indicate the timeline for this project. Choose an item.
Please indicate the funding status for this project. Choose an item.
If you already have funding for this project, please include the funding source and amount below. Also include the reason you are requesting additional funding.
Funding source: Click here to enter text.Funded amount: Click here to enter text.
Reason/justification for requesting additional funds: Click here to enter text.
Will you be earning course credit for this project? Choose an item.
If yes, please explain briefly how the project goes above and beyond normal course requirements.
Click here to enter text.
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Project Details:
Respond to the following prompts on a separate page.
- Please describe your project objectives to a non-scientific audience. Be sure to include information about your hypothesis and methodology. (500 words or less.)
- How will your work on this project impact your learning? What skills do you hope to develop as a result of participating in this research? (250 words or less.)
- How do you plan to disseminate your results to the campus community and the larger scientific community? (250 words or less.)
Application Checklist and Signatures
☐ I have completed the application.
☐ I have attached my responses to the Project Detail prompts.
☐ I have attached the Budget and Budget Justification Form.
Applicant Signature: ______Date: ______
Faculty Research Advisor Signature: ______Date: ______
(Faculty Research Advisors: Please note that by signing your name to this form, you are indicating that you have reviewed this application and the supporting documents and are confirming your endorsement and supervision of the aforementionedresearch project.)
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