Date
/ CC-STARS!
(Community College – STEM Training and Retention of Students)
Grant Proposal

All Principal Investigators and faculty mentors are required to be U.S. citizens. Community colleges may request a maximum budget of $32,880, and 4-year universities may request a maximum budget of $5,000.

Faculty Principal Investigator:

Last First Initial

Position/Title: / Department:
University: / Employer Identification No.

Street Address Room Number

City: / State: / ZIP Code:
Project Title:
Desired Outcome:
Time Frame:
Total OSGC Funds Requested: / $

Indicate where and to whom check should be sent!

Faculty Principal Investigator Printed Name
and Signature:

I certify that all above information is correct, and that I understand the citizenship requirements and will abide by said requirements.

OSGC Campus Representative Signature:

The Ohio Space Grant Consortium is largely supported through Federal funding. As such, the following information is requested for statistical record keeping. Please mark the boxes accordingly.

GENDER: / Male / Female
ETHNICITY: / Hispanic or Latino / Not-Hispanic or not Latino

RACE:

American Indian / Black or / Native Hawaiian / White / Asian / Some
or Alaskan / African / or Other Pacific / Other
Native / American / Islander / Race
I am a person with a disability. (A disability that limits a major life activity)
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CC-STARS! (Community College – STEM Training and Retention of Students) Grant Proposal)

(Continued)

Brief Description of Project: (Attach additional pages if needed).

Desired Outcomes: (Attach additional pages if needed).

Attachment #1 - Budget: Note: All P.I.s and faculty mentors are required to be U.S. citizens.

Community colleges may request a maximum budget of $32,880, and 4-year universities may request a maximum budget of $5,000.

Attachment #2 - Curriculum Vitae (CV): Attach CV of the Principal Investigator(s) PI(s) and CoPrincipal Investigators (if applicable).

Reporting Requirements: At the end of the project, the following two reports will be required:

1)  Brief Final Report – Include accomplishments and actual program expenditures.

2)  NASA/OEPM (Office of Education Performance Measurement) Report – Include participant demographic information, etc. Report template will be distributed to PI along with grant award.

Please submit this form and any accompanying documents as a single PDF file to:

CC-STARS! (Community College – STEM Training and Retention of Students) Grant Proposal Page 2 of 2