Faculty Member(s) with Department(s)
If more than one faculty member in group, please indicate PI.

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Student participants, including degree program and anticipated date of graduation for each. Please note this list must include at least one undergraduate and at least one graduate student.

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Chair of PI Department: please indicate that you have reviewed this proposal and agree that the PI’s involvement will be of benefit to the University and to the student participants. Your signature also confirms the availability of departmental staff support to assist the PI with distribution of the funding for travel arrangements, etc.

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SignatureDate

Intended Host Country: ______
Host Institution or Community: ______
Total Requested Funding: ______
Anticipated Program Dates: Start ______End ______
(The 2016 application is for all programs to take place Summer 2016, Winter Break 2016, or Spring Break 2017.)

Application Checklist
The below items must be submitted, in one packet, to Dowling 710, no later than
12:00 Noon on Friday, March 4, 2016.

  1. Application Form
  1. Proposal

In no more than four pages, the Proposal should detail a plan for all aspects of the research and include specific responsibilities of members of the host community as well as those of each member of the Tufts team. All members of the team should be involved in preparing this collaborative piece.

  1. Travel Itinerary

Ideally, all members of the group will travel together at all times.

  1. Budget

A full, itemized budget for all pieces of the proposed program. Travel, accommodations, meals, and research-related expenses should be listed in the single budget. Please note that compensation for host community members and/or non-specified stipends for group members will not be considered for funding.

  1. Personal Statements

Each member of the team should submit a brief statement explaining what he or she hopes to gain from the program and the part this experience will play in his or her educational and career plans.

  1. CVs & Transcripts

Faculty members, please submit a full CV.

Graduate students: please submit your CV and unofficial graduate-level transcripts.

Undergraduates: please submit an unofficial copy of your Tufts transcript and any additional college-level academic work not represented there. Do not submit a resume.

  1. Preliminary Agreements
    Faculty members (and post-docs), please complete the “Faculty Agreement,” indicating non-PI status if applicable.

The “Participant Agreement” should be completed by all graduate as well as undergraduate students.

Faculty Agreement

Name: ______

Title: ______Dept: ______

Primary Investigator for Group? Yes / No
PI only

I understand that I will be responsible for the management of all granted funds for my group, if awarded. I will oversee all project arrangements, including travel, accommodation, visa, and research clearances, as applicable.

I understand that I am considered the supervisor for all other participants of the group while abroad and will set expectations for professional and personal behavior in the context of the host country and culture(s).

I will contact my department chairperson immediately in the event that a participant’s safety or well-being may be at risk.

All faculty members

I understand that all student participants are expected to adhere to the same academic and social responsibilities expected of them during the academic year, and that I must report any breach of the Tufts Code of Conduct or Academic Integrity policy of which I become aware.

I will not involve myself or other members of my team in dangerous situations, nor will I involve myself in political activities of any kind while in the host country.

I agree to leave the host country immediately in the event that the State Department issues a travel warning to the country and/or a representative of Tufts University mandates the termination of the program for safety reasons.

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Signature Date

Country ______Project ______

Team Members ______

Participant Agreement

Name: ______

I understand that I am responsible for all travel planning, including but not limited to securing an appropriate Visa, getting all recommended vaccinations, and confirming health insurance coverage.

I understand that the Tufts faculty member identified as Primary Investigator (PI) for this research is my supervisor while abroad. I agree to heed his/her advice both inside and outside of the research location.

I understand that I will remain a member of the Tufts community while abroad, adhering to the same academic and social responsibilities expected of me during the academic year, as outlined in the Code of Conduct:

I will not involve myself or other members of my team in dangerous situations, nor will I involve myself in political activities of any kind while in the host country.

I agree to leave the host country immediately in the event that the State Department issues a travel warning to the country and/or a representative of Tufts University mandates the termination of the program for safety reasons.

Should I have any questions about the above stipulations, at any time, I will contact my PI immediately to discuss my concerns.

(Undergraduates only) I will present my International Research Program work at the Undergraduate Research & Scholarship Symposium (Spring). I will also seek out and take advantage of additional opportunities to present or publish my work with members of my team.

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Signature Date

Country ______Project ______

Team Members ______