APPLICATION FOR THEARTS & HUMANITIES FACULTY FELLOWSHIP PROGRAM

PROJECT INFORMATIONDate of Submission:

Applicant: Title and Department:

Co-Applicant(s): Title and Department:

Telephone: ______ Email:

Project Title:

Department Financial Administrator:______

The Arts & Humanities Fellows Selection Committeestrongly urges applicants to utilize the services of the Center for Research Program Development and Enrichment ( in developing proposals for the Arts & Humanities Faculty Fellowship Program.

BUDGET SUMMARY (complete all applicable categories)

ITEM

/

AMOUNT

/ ITEM /

AMOUNT

Salary Replacement* / $ / Travel / $
Equipment / $ / Computer Hard/Software / $
Other: / $ / Personnel/Stipends / $

TOTAL BUDGET REQUEST: $______

The amount budgeted for salary replacement must be negotiated with the department chair prior to proposal submission (maximum of $20,000).

CONFLICT OF INTEREST DISCLOSURE

Describein the space provided below any conflicts of interest that may exist, or may be perceived to exist between any current members of the Arts & Humanities Fellows Selection Committee and you, your co-applicants, and other investigators on the project. This includes individuals on the Committee who: are in your department or program; have a financial interest or formal relationship with any company or other non-OU organization involved in your proposal; are related (spouse, child, sibling) to you or co-applicants or are participants in the project; or who,in any way because of their review of your proposal, compromise the integrity of the review process. Please direct questions to the Selection Committee Chair.

SPECIAL CONSIDERATIONS

If the project involves any item(s) listed below, please check the appropriate box(es). Formal written approval from the appropriate organization (e.g., IRB, IACUC, Export Controls Office, Biosafety Committee) must be provided to the Office of the Vice President for Research prior to the receipt of Arts & Humanities Faculty Fellowship funds.

[_] HUMAN SUBJECTS [_] LABORATORY ANIMALS [ ] EXPORT CONTROLS

[_] RADIOISOTOPES[_] BIOHAZARDS [_] RECOMBINANT DNA

[ ] TOXINS[ ] OTHER

ABSTRACT OF THE PROPOSED ACTIVITY

In 200 or fewer words, describe in the space below the proposed project in a manner that a non-expert can understand and also describe the expected scholarly outcome(s) and impact(s).

SIGNATURES

Your signatures formally indicate your consent for the proposal to be reviewed by members of theArts & Humanities Fellows Selection Committee, all of whom agree to hold in strict confidence the contents of the proposal and any recommendations made upon it.

This is a reimbursement program. If funded, the OVPR commits to reimbursing the Department for expenditures up to the award amount. The reimbursement will be made after the completion and approval of the Final Report. The Final Report must be completed within the time frame outlined in the award letter.

SIGNATURE OF APPLICANT:

SIGNATURE OF CO-APPLICANT(S):

SIGNATURE OF DEPARTMENT CHAIR(S)/DIRECTOR(S):

SIGNATURE OF DEAN(S)/ASSOCIATE DEAN(S):