Application for MDSGC RockOn Sponsorship

1. Mentor Information

This form is intended to be completed by a prospective Maryland RockOn team mentor seeking Maryland Space Grant sponsorship for the workshop fee and/or travel support for participants. Prospective mentors must also complete the RockOn Workshop application found at https://www.nasa.gov/wallops/stem/rock-on/.
Mentor's Name*

FirstLast
Mentor's Email*
example@example.com
Mentor's Institutional Affiliation and Department*
e.g., UMBC Mechanical Engineering
2. Follow on project plans and student selection
What project(s) do you/your institution have planned for the following academic year that will be enabled or strengthened by taking students to RockOn this year?*
What qualifications are you looking for in prospective student participants and was there or will there be a competitive selection process? If students have already been selected, provide their names and email addresses as part of the response. Note that all team members (faculty and students) must be U.S. citizens at least 18 years old. Students must not have already graduated from their current program prior to the workshop.*
3. Desired sponsorship budget (approx)
If selected by NASA to attend the workshop, are you seeking MDSGC sponsorship for the $4000 workshop fee?*

Yes, I would need MDSGC to sponsor the workshop feeNo, I have other resources I can use for this
If selected by NASA to attend the workshop, how much travel support would you require from MDSGC to enable all participants to attend? Provide an approximate budget including transportation, lodging, meals and incidentals. If any travel funds will be contributed from another source, indicate the amount.*
4. Additional information and certification
Any other information you would like to share regarding your RockOn plans (optional):
By submitting this form: I hereby certify that I am the prospective mentor identified above and that the information I am submitting is accurate to the best of my knowledge. I acknowledge that Maryland Space Grant sponsorship is contingent on the availability of funds and awarded on a competitive basis among applicants.
Should be Empty:

1. Mentor Information

2. Follow on project plans and student selection

3. Desired sponsorship budget (approx)

4. Additional information and certification