Ohio Space Grant Consortium Seed Grant s1

Date
/ OSGC Curriculum Innovation Proposal (CIP)
Grant Application
Proposal Deadlines: None – Accepted At Any Time

(The objective of the Curriculum Innovation Proposal (CIP) is to support new, innovation curriculum development to support the development of STEM higher education in areas supported by NASA. Curriculum developments that that can be shared with other schools are especially preferred. The total budget request is limited to $5,000.)

Faculty Principal Investigator:

Last First Initial

Position/Title: / Department:
University: / Employer Identification No.

Street Address Room Number

City: / State: / OH / ZIP Code:
Telephone: / ( ) / Email Address:
Project Title:
Total OSGC Funds Requested: / $

Indicate where and to whom check should be sent if different from Faculty Principal Investigator:

Name

Street Address Room Number

City: / State: / OH / ZIP Code:
Faculty Principal Investigator Signature:

I certify that all above information is correct, and that I understand the citizenship requirements and will abide by said requirements.

OSGC Campus Representative Signature:

Continue with Page 2.

OSGC Curriculum Innovation Proposal (CIP) (Continued)

1. Brief Description of Project (5 page maximum as an Attachment). Indicate desired outcomes, timeframe, and expected funding agency for follow-on proposal (if applicable).

2. Faculty Participant(s) (Note: U. S. Citizenship is required.)

Name / Department / Email Address / Telephone
( )
( )

3. Other Participants (Note: U. S. Citizenship is required).

Include TOTAL NUMBER of Students, Staff along with the following additional information.

All direct-funded students will be required to complete an Information Form with additional demographic information.

TOTAL / GENDER / STATUS / ETHNICITY / DISABILITY / MILITARY
VETERAN
M / F / UG / G / Hispanic
or Latino / Not Hispanic or Latino
TOTAL / RACE
American
Indian or
Alaska Native / Black or
African
American / Native Hawaiian
or Other
Pacific Islander / Asian / White / Some
Other
Race

4. Proposed Budget (Attachment #1): Attach spreadsheet. NOTE: NASA requires 100% in cost-sharing, and no indirect charges are allowed, but waived overhead does count as cost-sharing. Costsharing may also include “in-kind” contributions [i.e., faculty time (i.e., salary and fringe benefits), university lab facilities, meeting space, waived tuition, etc.] Total budget request limited to $5,000.)

5. Curriculum Vitae (CV) (Attachment #2): Attach CV of the Principal Investigator(s) PI(s) and Co-Principal Investigators (if applicable).

6. Reporting Requirements: At the end of the project a brief final report is required outlining accomplishments, publications, proposals submitted, and actual expenditures along with a NASA report (to be sent along with award letter and check). Note that any peer-reviewed scientific research publications authored or co-authored by investigators funded are required to ensure that those publications are submitted to PubMed Central system at www.ncbi.nlm.nih.gov

All Reporting forms are also available on the OSGC website at the following link: http://www.osgc.org/cip.html

7. Grant Activity Photos: Any photos would be appreciated for OSGC/NASA publicity purposes! ANASA Release form is needed to accomplish this, and is also available online at: http://www.osgc.org/pdf/NASA-AdultMediaReleaseForm.pdf

Please submit this form and any accompanying documents as a single PDF file to:

OSGC Curriculum Innovation Proposal (CIP) Page 2 of 2