Application for Faculty Scholarship Funds
Wheaton College
Budget Year
Name:Department
Part I. Requests for Funding
A. Conference
1. Participation (delivering paper, speaking on panel, etc.) $1200 maximum;
2. Attendance $800 maximum
Name of conference or sponsoring group:
Destination:Dates of trip:
Please indicate if you plan to: (please circle all that apply)
attendance onlydeliver a paperspeak on a panelchair a session
Paper, panel, or session title: ______
B. Scholarship - $1200 maximum
Description of Project: (Please provide a precise explanation of what you plan to do. Attach an extra sheet if necessary.)
______
______
______
______
All research and teaching projects involving vertebrate animal species, whether conducted by faculty or students, must be reviewed and approved by IACUC (Institutional Animal Care and Use Committee). Similarly, all projects involving human subjects must be reviewed and approved by the IRB (Institutional Review Board.) (please circle one and/or both that apply)
Has your project been approved by the IACUC -Yes -No
Has your project been approved by the IRB-Yes-No
Note – All equipment purchased with college funds becomes the property of Wheaton.
Have you applied for other sources of funds inside or outside of Wheaton College for this project?
Yes No
If yes, please list them here.
______
______
Have you received assistance from the Faculty Research Funds within the last two years?
Yes No
If so, please attach a copy of your report.
Part II. Itemized Expenses
An itemized estimate of expenses must be approved before the trip is taken, or scholarship expenses are incurred. Payment in excess of the estimated amount will not be reimbursed.
For trips, a final accounting with appropriate receipts must be filed in the Provost’s Office within one week of the completion of the scholarship trip and no later than June 30.
For scholarship: report of your scholarly work will be due in the Provost’s Office no later than June 30 and all expenditures are to be documented with receipts.
Funds on which reports are not filed, and/or receipts not submitted, by June 30 will be deducted from your allocation for the following fiscal year.
A. Conference
Application Fees: $
Airfare:$
Other transportation:$
Hotels:$
Meals:$
Other Expenses:
______
______
______
B. Scholarship
______
______
______
______
______
______
Total Requested: $ ______
Please print out and sign a copy of this form. Make a copy for your records and for filing your final expense accounting. Submit the original to the Provost's Office.
Signature: ______Date: ______
Committee Action: / Date: / Amount Granted:$______
2/09