Scholar Grant Application

Date Application Submitted: ______

Name of Project:______

Student Requesting Funds:______

Year in School/Major:______

Campus Address:______

Email:______

Phone:(_____)______

Campus Minister for Vocational

Discernment Group:______

Contact person administratively responsible for the project:

Name:______

Address:______

Street City State Zip

Phone:(_____)______

Location & Date(s) of Project:______

______

Sponsor(s) of Project:______

Address: ______

Street City State Zip

Estimated # of Duke students/participants: ______

Estimated # of Duke staff participants: ______

Total funds requested: ______

Has this project receivedPathWays grants before? YES NO If so, when? ______

When are the funds needed: ______

Preferable: The fund code to which funds should be transferred in lieu of check: ______

Name of code: ______

(Possible, but not preferred) Name of organization to which check should be written: ______

______

Tax ID of the organization (required):______

Address of the organization: ______

City: ______State: ______Zip code: ______

*SSN required if check to be payable to an individual (will be taxable income): ______

______

**Attach a description of the programs(s) or agency(ies) of sponsorship, including brochures or other printed material, if available. Describe the supervision involved. Describe the organization, its mission, with whom you will be working, and what preparation or training is involved.

Please provide the following information (no more than 750 words, single-spaced is necessary for a response to each section). Should you feel the need to go into further detail, you may append extra material (brochures, pictures, etc.). However, the following information must be submitted independently:

  1. Statement of proposed plans:
  1. What do you hope to accomplish?
  2. How do you plan to achieve your goal?
  3. Why do you feel a need for this project in your Duke career?

D.Describe your vocational discernment journey and the role this project might play in your discernment process.

  1. Statement of funding:
  1. What is your total working budget for the entire project, noting funds you are requesting from PathWays at Duke Chapel? Please itemize your budget.
  2. Specifically, how do you plan to use PathWays money, if granted?
  3. To what other sources of funding have you made requests for support?
  4. Why are you requesting PathWays support?
  1. Sealed Letter of recommendation:

A. Please submit a sealed letter of recommendation from your Vocational

Discernment Campus Minister on professional letterhead with your

application.

AGREEMENT UPON RECEIVING GRANT:

Projects receiving grants must agree to provide two out of the three post-mission reports within two weeks from the date of return from the field:

  • a writtentwo-page (double-spaced, 12pt font) summary/evaluation of the completed project;
  • a written story of at least two typewritten pages (double-spaced, 12pt font), along with a PowerPoint slide presentation, videotape or picture album describing the ministry funded; and
  • report or provide a program to a campus ministry group or residence hall during an academic year.

To Be Completed by PathWays Staff

Date Reviewed ______ٱ Approved ٱ Denied ٱ Returned for more information

Amount approved $ ______from fund code:______code name: ______

ٱ G/L account domestic travel ٱ G/L account foreign travel

ٱ other G/L account:______

Signed: ______

Date application notified by PathWays:______

Date the payment/transfer was made to the individual or group: ______

Initials: ______

Date the follow-up report was received: ______

______report ______pictures/or other media ______other documentation

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