Iowa State University

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Academic Advising Innovation Grant Program

2016-2017 Application

Instructions:

Complete application form below.

Submit application form to . The application and supporting documents must be emailed as a single pdf file containing the following materials:

1) all sections completed in the application below (Don’t feel limited by the table/boxes within each section below. Feel free to expand them in order to provide the most detailed information possible)

2) a detailed budget using the template provided

3) a signed application form, up to six pages

For questions about grant eligibility or the application process, contact .

Award notifications will be made on a rolling basis. Grant applications will be reviewed by the committee in late-July, September, November, January, and March. Grant recipients will be asked to share program highlights or project results/data at an advising event on campus in Spring 2017.

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Initiative/Project Title:
Name of Primary Applicant:
Department/Unit/College:
Campus Address:
Telephone:
Email:
Amount of funding requested:
Name of Secondary Applicant(s),
if applicable:

Type of funding requested: ______One-time Funding _____ Pilot Project ______Seed Funding*

*If requesting seed funding, please describe how program will be funded in the future

1.  Abstract /summary of the proposal (250 words or less):

2.  Body of the proposal

a)  Provide introduction and/or statement of problem.

b)  List objectives/intended learning outcomes.

c)  Describe the proposed initiative and address the criteria listed in the guidelines.

d)  Describe how the learning outcomes will be evaluated

3.  Implementation timeline for the initiative (Potential expenditure period from start date through 6-30-2017).

Task / Completion Date

4.  List other individuals/organizations collaborating on the initiative.

5.  Budget: Please include a detailed budget noting any demonstrated financial commitment from your or other supporting departments. You may alter the budget table below to fit your needs. The most common items/categories are included as a guide.

a)  In order to help the grant review committee make the best funding decisions, please include the following information in your budget, if applicable.

i.  Student hourly payroll: Approximate number of hours per week and the hourly pay rate.

We encourage using the average undergraduate student worker/peer mentor pay rate of $8-10/hour.

ii. Hospitality: Number of events and estimate reasonable food/drink costs per event

iii.  Technology upgrades or related projects: Include bids from external vendor or hourly rates for ISU Web Development services.

iv.  Other common categories include: Travel/Transportation, Supplies/Services/Books, etc.

Item* / Funding Source
(your office, grant) / Approx. Cost
Payroll (Student Hourly rate: $ ______)
Travel/Transportation
Hospitality (# of events/average cost per event)
Supplies/Books/Services
Technology/Software
Other:
Other:
Other:
Total:

*Providing as much detail as possible in your budget will greatly assist the review committee in their funding decisions.

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, correcting expenses as needed and providing an end of year impact report no later than June 30, 2017.

Financial Responsibility

I agree to take financial responsibility for the proposed project

Signature Date

Printed Name Title

Endorsement of the proposed project: The department chair or supervisor of the primary grant applicant has agreed to endorse the proposed project.

Chair/Supervisor (signature) Date

Chair/Supervisor (printed name) Title

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