Submit Completed Application to the
Office of the Provost and Executive Vice President for Academic Affairs
20 Seerley Hall, 0707
2016-2017 Deadlines: /September 8 January 12
/ACTION OF COMMITTEE
October 6 February 2
/November 3 March 2 / Date Received ______
December 1 April 6 / [ ] Approved $ ______
May 4 / [ ] Not Approved
INTERCOLLEGIATE ACADEMICS FUND APPLICATION
Please Read the IAF Guidelines Before Completing This Form
Application Must be Typed
Date of Application:
Name of Group/Department:
Number of Students Applying:
Student Information (Please attach additional sheet if more than 8 students are attending)
Name
/ID #
/Undergraduate (U)/Graduate (G)
Faculty or Administrative Sponsor:
Event Information
Name of Event:
Location:
Date(s):
PLEASE ATTACH - Event Brochure/Program –and– provide event website URL:
Project Title and Description (Briefly describe your project/presentation and each person’s role in it.)
How does your participation in the event demonstrate original research, scholarship or creative work that goes beyond standard classroom learning/assignments?
Activity Type: (Please mark the applicable box)
NOTE: THERE MUST BE EVIDENCE OF EXTERNAL REVIEW.
Presentation A copy of your external acceptance letter and an abstract of your presentation must be attached.
Academic Competition A description of the competition and copy of your qualification or external merit-based
invitation to complete must be attached.
Invited Performance A description of the event and a copy of the external merit-based invitation must be attached
Other Describe and include verification of your participation:
Budget Information
Use the template on the next page to complete a budget specifying costs for the group for basic registration, housing and transportation. IAF does not pay for meals, membership dues, visas or presentation supplies/materials. Please be as specific as possible. Attach a conference program, registration materials, airfare quote, and other materials, which document the costs listed in the budget. [Applications lacking a budget and documentation will NOT be considered.]
IAF can award up to $650 per student and $8,500 per group. Applications for travel outside of the United States and Canada may be eligible for up to $1,000 per individual (not to exceed the $8,500 group limit). Individuals, groups, and departments should normally expect to contribute a portion of the costs of the activity.
[Note: The guidelines and award amounts for 2016-2017 may be revised by the IAF committee at their first meeting in September.]
COMPLETE BUDGET WORKSHEET ON THE NEXT PAGE
BUDGET WORKSHEET
BUDGET CATEGORY / DETAILS / BUDGET AMOUNT / For IAF USE ONLY:REGISTRATION / Reg. Fee:
Number of students: / Total:
HOUSING
Hotel/motel
In general, IAF funds hotel costs at a rate of 4 students per room. / Nightly cost per room inc. tax:
Number of rooms:
Number of nights: / Total:
TRANSPORTATION
Airfare / Airfare costs per person:
Baggage fees per person: / Total:
TRANSPORTATION
Shuttles/Taxis/Charter Bus/City Buses
/ Type of Vehicle:
Costs: / Total:
TRANSPORTATION
UNI Motor Pool Lease
Estimate mileage:
2016 Rates: .27/mile
http://www.uni.edu/obo/accounts-payable/travel-guidelines#mileage-reimbursement-rates / Number of Miles Round Trip:
Total Costs:
SEE THE LAST PAGE OF THIS APPLICATION FOR INFORMATION ON ESTIMATING
UNI MOTOR POOL COSTS. / Total:
TRANSPORTATION
Personal Vehicle
Personal vehicles are reimbursed at the University mileage rate of 27 cents per mile. Use links above to estimate mileage. / Number of Miles Round Trip:
Mileage Rate .27 x Miles
= Mileage Reimbursement
Number of vehicles: / Total:
TRANSPORTATION Rental Car / Rental fees:
Fuel costs: / Total:
TRANSPORTATION
Parking Fees / Parking Fees: / Total:
TOTAL EXPENSE / Total:
Other Expected Funding for this Activity
Name of Source
/Amount Requested
/Indicate whether denied, pending or approved
Amount Requested from Intercollegiate Academics Fund:
How would attendance at this event benefit this group and the campus as a whole?
How will you share your experience and knowledge gained from participating in this activity with the UNI campus?
We acknowledge that we have read the IAF Guidelines and verify that the above information is accurate to the best of our knowledge. If plans change, we will promptly inform the Office of the Executive Vice President and Provost. Signatures below constitute agreement to abide by the “Intercollegiate Academics Fund Guidelines.” Please review the guidelines and IAF Application Checklist before submitting this application.
______
Student Representative Signature Date Faculty Sponsor Signature Date Phone
Email ______
Phone ______
Department Head Signature* Date Phone
*Department Head’s signature signifies you have read the entire
application and have concurred that the guidelines have been met.
[NOTE: A completed Intercollegiate Academics Fund Report is required in order for reimbursement to take place. This form is attached to the award e-mail sent to the faculty sponsor and is also available on the Forms Repository. Reimbursement requests MUST be made within 21 days of the completion of the trip. After 21 days the award is cancelled and funds are returned to the account for future applicants. See next page for details on submitting travel reimbursements.]
The University of Northern Iowa requests this information for the purpose of considering your application. No persons outside the University are routinely provided this information. Responses to all items are required. If you fail to provide the required information, the IAF Committee will not to act on this application. Date Revised: September 2016
SEE NEXT PAGE
IAF Application Check List
(Application must be typed)
I have reviewed the requirements below and attached the appropriate documentation for the type of activity in which I will be participating.
Activity Type
Presentation: A copy of your external acceptance letter and an abstract of your presentation must be attached.
Academic Competition: A description of the competition and copy of your qualification or external merit-
based invitation to compete must be attached.
Invited Performance: A description of the event and a copy of your qualification or external merit-based
invitation must be attached.
Other: A description of the activity and verification of your participation must be attached.
I have attached the budget documentation required for the expense type.
Budget Information
Registration – Include conference brochure or other documentation that notes basic registration amount.
As noted in the IAF Guidelines, membership fees are not an allowable expense.
Housing – Include hotel quote, conference brochure or other documentation detailing the amount of the housing expense. Please note that groups are expected to share rooms at a rate of 4 students per room with allowances made for gender.
Travel – Include quotes for airfare; a UNI Motor Pool quote or the Motor Pool Budget Worksheet on the last page of this application and a copy of current UNI Motor Pool rates; or a vehicle rental quote from an off-campus vendor. If traveling by personal vehicle, mileage is reimbursed at a rate of .27 cents per mile* for travel to and from the event only. Mileage is calculated using the university guidelines found at: http://www.uni.edu/obo/accounts-payable/travel-guidelines#mileage-reimbursement-rates.
*Note: Do not list estimated fuel cost on the budget, as fuel is covered in the per-mile rate.
Points to remember:
· Students do not receive funding support to attend more than one meeting in any given fiscal year (July 1 to June 30), so be certain not to include anyone on your application form who has been funded previously.
· Faculty sponsor expenses should not be included in the student budget.
Reimbursements for Travel Expenses:
Students must go to the department office prior to the trip to receive authorization to travel from the department. Any questions about travel authorization should be directed to your Faculty Sponsor.
Within 21 days of returning from travel, the following documents must be submitted electronically to the department office or the award will be forfeited:
1. IAF REPORT FORM describing your experience at the event. Only one form is needed per group and only students awarded funding should be included in this report.
2. Original Receipts
3. Conference Brochure (At least cover and conference itinerary)
UNI Motor Pool Information
The UNI Motor Pool leases vehicles for UNI activities. If you are considering using a UNI Motor Pool vehicle:
1. Call the Motor Pool at 273-2610 to discuss your options and ask if your group/drivers are eligible to lease Motor Pool vehicles.
2. Visit the Motor Pool website (UNI Motor Pool Rates ) to estimate costs.
3. If you decide to lease a UNI Motor Pool vehicle, document your cost estimate by attaching a quote from the Motor Pool or by filling out the worksheet below and attaching a copy of current Motor Pool rates.
UNI Motor Pool Budget Worksheet
Note that the Motor Pool has multiple charges for each rental. Rates vary by type of vehicle rented, length and time (weekend or weekday) of rental. Please see UNI Motor Pool Rates for a complete list of vehicle rental rates, mileage rates, and potential additional charges and fees.
Estimate COSTS: / For IAF USE ONLYDates Vehicle to be Leased:
Type of Vehicle Leased: / Lease Cost per Vehicle at Daily, Weekly,
Monthly or Weekend Rate:
Number of Miles for Round Trip: / Mileage Rate x Miles
= Mileage Cost
Number of Vehicles: / Total Costs per Vehicle:
Total Estimated Cost:
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