St. Mary’s University ON-CAMPUS GRANT PROGRAM Cover Sheet

St. Mary’s University
ON-CAMPUS GRANT PROGRAM
Cover Sheet
Type of Grant: Community Partnership
Distance Learning
New Faculty Start Up
Mini Grant
Pedagogical/Andragogical
Research
Scholarship of Teaching and Learning
Proposal Title:
Research funds requested: $_______________________________
Research Category: Applied
Basic
Scholarly/Creative Activity
Teaching
__________________________________________________
Principal Investigator
_____________________________
Department
________________________________
email
__________________________________________________
Co-Principal Investigator
_____________________________
Department
________________________________
email
A Time Line (Action Plan) has been included with this proposal.
I have,
I have not applied for OR received external funding this past year.
A detailed breakdown of proposed travel expenditures is included with this proposal.
I am requesting an RA (up to 1 FTE)
Does this proposal involve:
¼ time
Animals
Hazardous Materials
Human Subjects
½ time
¾ time
Prior to the start of the project,
investigators whose project involves
human subjects and/or animals are
required to obtain full approval from the
StMU IRB or IACUC
Signatures:
___________________________________________________________________
Date _____________________
Principal Investigator signature
___________________________________________________________________
Date _____________________
Department Chair signature
___________________________________________________________________
School Dean signature
full time
Date _____________________
Proposal Title
Project Summary
INSERT PROJECT NARRATIVE AND LITERATURE CITED HERE
Project Narrative
(limited to 10 pages double spaced)
Literature Cited
Time Line (Action Plan)
Please provide the following information:
Estimated number in each of the following categories to be directly affected by the activities
of the project during its operation:
Undergraduate Students: ______
Graduate Students:
______
Faculty:
______
Please provide estimated timeline of your project:
Budget Form
Budget Period: 6/1/15 to 5/14/2016
Principal Investigator: __________________________________________________________________________________________
1. Student Wages (regular):
$ _____________________
Minimum wage is $7.25 p/h. Maximum wage is $10.00 p/h. Student must be enrolled in a minimum of 6 hours for
graduate or undergraduate. The VP of Academic Affairs must approve higher hourly wages.
2. Supplies and Materials:
$_____________________
Itemize and justify on budget justification.
3. Equipment:
$_____________________
Itemize and justify on budget justification.
4. Travel:
$_____________________
Travel expenses for purposes of data collection only ie, fieldwork, travel to research site, etc will be
supported. Participation in conferences, workshops, seminars, or participation as a volunteer officer in a
professional organization cannot be funded by this grant. Itemize and justify on budget justification. *Please
apply for Faculty presentation grants for funds to present at conferences through your dean.
5. Contractual or Professional Services:
$_____________________
Itemize and justify on budget justification.
Total $_____________________
I will use the funds as outlined above. If the amount awarded is different from the amount
requested or if I modify any aspect of this budget, I will furnish the Office of Academic
Research and Sponsored Projects with a revised budget.
Principal Investigator:
For Office Use Only:
_________________________________________________________________
Signature
Budget approved
Date:
Date: ___________________________
Signature:
Budget needs revision
Detailed Budget Justification
(Use additional pages if necessary)
Will matching funds or funds from another source be used to directly or indirectly support the
proposed project? Yes
No
If yes, provide dollar amount, source(s) of funds, and describe how these funds will be used.
Previous Internal and External Grants Submitted
and/or Received during the past five years.
(Use additional pages if necessary)
Progress Report (on funded project from previous year)
Title of Previous Year’s Grant: _______________________________________________________________________________________.
Amount Awarded: $__________________________________
1. Did you complete the project?
YES ____
NO____
If no, please provide an explanation. (please limit to 250 words)
If yes, what were your conclusions? (please limit to 250 words) .
2. Were you awarded reassignment time?
YES ____
NO____
If yes, how many hours? ________________________________________________________________________________________
3. Was equipment purchased with previous award?
YES ____
NO____
If yes, how is it currently being used? ___________________________________________________________________________
4. How many students were engaged, involved or impacted? __________________________________________________________
5. How many faculty were engaged, involved or impacted? ____________________________________________________________
6. Did the results lead to one or more publication(s)?
YES ____
NO____
If yes, please list. _______________________________________________________________________________________________
7. Were the results presented at one or more professional conference(s)?
YES ____
NO____
If yes, please list. _______________________________________________________________________________________________
8. Have you or are you in the process of applying for external funding to provide additional funds for this project?
If yes, please list. _______________________________________________________________________________________________
9. Were any of the findings from your research implemented into the classroom?
YES ____
NO____
If yes, how? _________________________________________________________________________________________________
INTERT CURRENT CURRICULUM VITAE HERE
Current Curriculum Vitae
(maximum of three pages)
Reassignment Time Request (up to 3 hours maximum per Academic year)
Reassignment time is deducted from your grant award. Only the PI of the proposal is eligible for
reassignment time. If reassignment time is granted, the PI is not eligible to teach overload.
Principal Investigator: ____________________________________________________________________________________
Teaching load for the preferred semester, Fall, 2015
or
Course #
Section #
Course Title
Spring, 2016
# of Hours
Principal investigator is replaced for ______________ hours of reassignment time for research during the
Fall, 2015
Course #
or
Spring, 2016
Section #
semester, from the following course(s):
Course Title
# of Hours
The course will be taught by: ______________________________________________________________
Principal Investigator: ______________________________________________________________ Date: _____________________
Department Chair: __________________________________________________________________ Date: _____________________
School Dean: ________________________________________________________________________ Date: _____________________
Reassignment Time Justification
(Use additional pages if necessary)
Office of Academic Research and Sponsored Projects
Research Assistance Application Form (up to one F.T.E.)
RA stipends will pay for research related work @ $7.25/hr (undergraduate student) or up to $10.00 /hr (graduate student) for 16 weeks
for one (Fall) or both (Fall & Spring) semesters. Students must have a minimum of 2.5 GPA for undergraduate students and 3.0 GPA
for graduate students and be enrolled in 6 hours. Assistants are only allowed to work on campus a maximum of 20 hours per week in
assistantship positions (RA and/or TA). Pending availability of funds, students will also receive a partial tuition waiver each semester.
Name: __________________________________________________________________
Student ID#._____________________
To be appointed as a:
Research Assistant, Graduate
Research Assistant, Undergraduate
Full Time (20 hours per week)
¾ Time (15 hours per week)
½ Time (10 hours per week)
¼ Time (5 hours per week)
Resident
Non-Resident
Student will be supervised by:
_______________________________________________ __________________________________________
_____________________
Name
STMU ID#
Title
_______________________________________________ __________________________________________
_____________________
Department
Ext. Number
Email Address
Student Details for Correspondence:
Phone: __________________________________________
E-mail: ________________________________________________
For Office Use Only
Resident
Non-resident
S ID: ……………………………………….….………
Hours/week: …………………………………………
Hourly wage: ………………………………………..
Total Hours: …………………………………………
Total Stipend ………...…………………….h
Required Signatures:
_________________________________________________________________________
Date: __________________________
Department Chair signature
_________________________________________________________________________
School Dean signature
Date: __________________________
Reviewer Recommendation Form – Required Documentation
Thank you for taking the time to complete this form. As our Faculty On-Campus Grants program continues to grow, the
Office of Academic Research and Sponsored Projects is in constant need of qualified reviewers to take on the challenge
of providing fair and objective assessments of each application’s strengths and weaknesses. Reviewers should be nonSTMU employees and PhD level or education/experience equivalent individuals that are well respected in their discipline.
Below, please provide the name and contact information for potential reviewers that to your knowledge, best fits the above
criteria – to be vetted, selected, and invited by the OARSP to participate in the peer-review process associated with the
Faculty On-Campus Grant applications.
Do not provide the name and contact information for individuals that might be construed as creating a conflict of interest
because of past or current collaborations or other affiliations. This might include, but not limited to, past academic or
graduate school advisors, professional colleagues who you have collaborated with on research projects in the past,
professional colleagues who you are currently collaborating with on research projects, former or current undergraduate or
graduate students, etc. By providing the names below, the OARSP assumes that you have no conflicting affiliations or
interests. If you have names of colleagues who you do not want to review your proposal, please provide those names
and affiliations on a separate document and attach to your grant application packet. If you have any questions, please
contact the OARSP at 436-3720 or by email ([email protected]).
Name of PI: ________________________________________________________________________________________________________
Proposal Title: _____________________________________________________________________________________________________
___________
Title
_________________________________________________
First Name
_______________________________________________
Last Name
________________________________________________________________________________________________________________________
Mailing Address
__________________________________________________________
______________________________________________
Discipline
Institution
__________________________________________________________
______________________________________________
Email Address
Phone
___________
Title
_________________________________________________
First Name
_______________________________________________
Last Name
________________________________________________________________________________________________________________________
Mailing Address
__________________________________________________________
______________________________________________
Discipline
Institution
__________________________________________________________
______________________________________________
Email Address
Phone