CROOKSTON STUDENT RESEARCH AND CREATIVE WORKS FUND

Application for Spring 2018

Deadline to Department Head: 4:00 p.m. on November 17, 2017

A.  About You (all requested information must be provided)

Last Name, First Name
ID Number
Email Address
Best Telephone Number
Campus Address (UMC Box #)
Permanent Address – Line 1
Permanent Address – Line 2
Permanent Address - City
Permanent Address – State
Permanent Address - Country
Permanent Address – Zip Code
Major
Adviser
Total Credits Completed
Cumulative GPA
Exp. Graduation (semester & year)

B.  About Your Proposed Project (all requested information must be provided)

Project Title
Start Date of Project
End Date of Project
Faculty Mentor’s Name
Faculty Mentor’s Email Address
Number of Hours for the Project
Requested Expenses
(maximum expense dollars is $300)
Was this proposal also submitted to UROP in Minneapolis?
Have you received CSR/CW funding previously? If so, when?

C.  Your Responsibilities

·  Work with your mentor in developing this proposal.

·  Keep and submit to your mentor a weekly log of your work and a final report of your study and make a presentation to a class, seminar session, community group, and/or at a research fair.

I have discussed these issues with my mentor and understand what is expected during the activities of this proposal and upon completion.

Student’s Signature: Date:

D.  Mentor’s Responsibilities

·  Indicate how you will oversee the student’s work on the project.

·  Identify a schedule of consulting personnel to work with the student.

·  Complete the Verification of Project Start form verifying the student has started working on the project and send to

·  Work with the student in preparing the final report.

·  Evaluate the student’s work and final report.

·  Help find a classroom, seminar, community group, and/or research fair opportunity for the student to talk about their research experience.

·  Complete the Verification of Completion form verifying the student has completed the project and send to

I have discussed these issues with this student and have explained how I will work on each of these activities with this student.

Mentor’s Signature: Date:

E.  Department or Unit Head

I have reviewed and approved this application and attached proposal.

Department/Unit Head Signature: Date:

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