APPLICATION FORM

WILMINGTONCOLLEGEINSTRUCTIONAL DEVELOPMENT AND RESOURCES COMMITTEE MINI-GRANT PROGRAM

Please fill out the following electronic form completely and send to the Clerk of IDRC in the form (paper or electronic) required by the Clerk. Do not exceed four pages, includingbudget and this cover sheet. A confirmation of the receipt of your request will be sent to you via the email or phone number provided. If you do not receive a confirmation within one week of the application deadline, please contact the Clerk of IDRC. The three application deadlines are August 15, January 15 and April 15.

Date:

Faculty Name(s):

Faculty Title:

Area:

Email (of primary contact):

Phone (of primary contact):

Campus:

Title of Activity/Project:

Title, Date and Location of Meeting, as applicable:

Date and starting time of first event of meeting that you plan to attend:

Date and ending time of last event of meeting that you plan to attend:

If you are attending a meeting, please check or fill in all that apply:

Oral presentation
Length of presentation: minutes / Poster presentation
Panel member / Invited presentation
Regional meeting / International meeting
National meeting / Elected officer of relevant organization
Meeting organizer / Continuing education credits

Description of Activity/Project: Please complete each of the fields below to describe your activity/project. You are encouraged to expand each field space to accommodate a detailed description not to exceed 2 pages. Only if a field does not apply to your activity/project should you respond N/A.

  1. Purpose and objective of activity/project
  1. Research methods
  1. Detailed timeline of activity/project (action plan; include deadlines and due dates)
  1. Value of activity/project to College
  1. Student, colleague, community collaboration
  1. Evaluation Plan for activity/project (how will success be determined)
  1. Potential of project to generate external funds (describe and indicate amount)
  1. Other pertinent information

Budget:

Use the budget form below.

  • Fill in all amounts in the last three columns, placing zero’s where appropriate.
  • Please itemize and describe costs in the supplies, equipment and other categories in the “description of cost” column.
  • Please describe any “matching funds” in “additional information.”

Categories / Description of cost / Cost / Requested Amount from IDRC / Matching funds
Mileage / (RT Travel from to , miles @ $0.405 per mile) / $ / $ / $
Airfare / (RT Travel from to ) / $ / $ / $
Registration / $ / $ / $
Meals and Incidental Expenses (use government M&IE rate for city of travel, / ( days @ $ per day / $ / $ / $
Lodging (estimate) / ( nights @ $ per night) / $ / $ / $
Supplies / $ / $ / $
Equipment / $ / $ / $
Faculty stipend / Limit to $1000/faculty member / $ / $ / $
Student stipend / $ / $ / $
Other / $ / $ / $
Totals (total each column) / $ / $ / $
If you are planning on using your yearly faculty development money towards this project, subtract $300 here: / -$
Total amount requested from IDRC: / $

Additional information: Use the space below to clarify any points on the budget above: