Grant Verification Form

Grant Verification Form
I am: *

I am an applicant of a Consortium Affiliated College or University applying for a Grant I am the Campus Director for my institution

Applicant's Name: *

First Name Middle Name Last Name
Consortium Member Institution: *
Campus Director Email: *
example@example.com
Type of award applicant is applying for: *
Type a question *

I certify that the applicant indicated above either is currently enrolled as a full-time student or is faculty and meets the eligibility requirements, as outlined in the CT Space Grant Student or Faculty Application Booklet and as summarized below.
U.S. Citizenship *

U.S. Citizenship is a requirement of eligibility for all CT Space Grant College Consortium awards. Award recipients must provide proof of U.S. Citizenship in the form of one of the following (photocopy is acceptable): U.S. Passport (expired or unexpired); Citizenship Certificate; Naturalization Certificate; Birth Certificate; Military or Company ID Card that Shows Citizenship; or Certified Letter from some other organization that has verified citizenship. By checking this box, the applicant and the Campus Director confirm that the student is a U.S. citizen and proof has been provided.
Applicant Signature: *

First Name Last Name
Date: *

Month Day Year
Date

Campus Directors should check with OSP/Grant Office for any special requirement of each institution that is not included or required by NASA or CTSGC office.
Campus Director's Name: *

First Name Last Name
Applicant's Name: *

First Name Last Name
Do you approve of this application? *

I approve of this application I do not approve of this application
Reasoning: *