Fellowship Determination Questionnaire

Fellowship Determination Questionnaire

1.  Name of the Fellowship and or class it applies to

2.  Provide the FUND ______ORG ______Program ______

3.  Provide a brief description of the purpose of the fellowship

4.  Are the activities conducted by the individual directly related to the fulfillment of a grant or other contractual commitment of the institution and, if so, do these activities play an essential and valuable part in enabling the institution to fulfill its commitments?

5.  Is the individual subject to the kind of supervision normally given an employee?

6.  Is the individual required to maintain specified work schedules, like working a certain number of hours per week or month?

7.  Does the institution require the individual to submit progress or other reports in connections with the activities conducted?

8.  Are the stipend payments by the institution roughly the same amount as payments made to employees for similar work?

9.  Does the individual receive the same campus privileges (parking, etc.) as faculty and staff?

10.  Is the individual eligible for the same fringe benefits (health insurance, life insurance, etc.) as are regular employees of Grand Valley?

11.  Does the individual receive credit toward tenure as a result of conducting these activities?

12.  Is the amount of the stipend geared toward his or her previous salary?

13.  Are stipends increases geared to inflation or increased experience n the same manner as employee salary increases?

14.  If the individual is working on a governmental grant, do the terms of the grant require that the stipend payments be treated as wages or as a non-compensatory fellowship?

15.  If the individual were not conducting the activities for which the stipend is being paid, would the university hire an employee to conduct the same activities?

16.  Will the recipient’s be Students ___ Employees ___ or Non Students ___

Check all that apply

I certify that I have completed this questionnaire to the best of my knowledge. I have also attached any related documentation – such as grant agreement or job descriptions. I also certify that my department will notify the recipient that this is taxable income.

Preparer (Department):______Date:______

Determination: Is this a fellowship payment? Yes______No______

Reviewer (Business & Finance):______Date:______

4/22/2016