Student-Faculty Research Application

Student - Faculty Research Grant - Researcher Application

Please indicate your role in this application
*

I am a student applying with a Faculty Mentor I am the Academic Advisor for the Student Applicant I am the Campus Director for my institution I am a Faculty Member of a Consortium Affiliated College or University applying for a Grant I am a representative of the Office of Sponsored Programs approving a Faculty Member's Application

Student Researcher Information:
Applicant Name *

Prefix First Name Last Name
Enrollment Status *

Undergraduate Graduate
Consortium Member Institution: *
Official School Email Address: *
example@example.com
Campus Director Email: *
example@example.com
Current GPA *
Major: *
Expected Graduation Date *
U.S. Citizen *

Yes
Previous Space Grant Awards (Please list all; include title/date) *
Faculty Advisor for this Project: *

First Name Last Name
Faculty Advisor Email: *
example@example.com
Period of Performance *
Upload Your Narrative: *

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Student Transcript: *

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Resume/Curriculum Vitae: *

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Other (Optional):

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Faculty Researcher Information
Applicant Name *

Prefix First Name Last Name
Rank/Title: *
Official School Email Address: *
example@example.com
Consortium Member Institution: *
Campus Director Email: *
example@example.com
Office of Sponsored Programs Email Address: *
example@example.com
Do you have Tenure? *

Yes No
Tenure Status: *
Department: *
Dean of my College Email: *
example@example.com
Permanent Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Project Title *
Proposed Period of Performance (Latest Date Accepted: May 30, 2021): *
Budget Requested *
Match(1:1 Commitment Amount) *
Previous Space Grant Awards: *
How many Student Researchers? *
Email of Student Researcher #1: *
example@example.com
Email of Student Researcher #2: *
example@example.com
Email of Student Researcher #3: *
example@example.com
Email of Student Researcher #4: *
example@example.com
Email of Student Researcher #5: *
example@example.com
Email of Student Researcher #6: *
example@example.com
Email of Student Researcher #7: *
example@example.com
Email of Student Researcher #8: *
example@example.com
Email of Student Researcher #9: *
example@example.com
Email of Student Researcher #10: *
example@example.com
Upload Your Proposal Abstract: *

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Upload Your Narrative: *

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Cancel of
Budget Worksheet: *

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Cancel of
Curriculum Vitae: *

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Cancel of
Other(Optional):

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Grant Verification Form:
Applicant Name: *

First Name Last Name
Consortium Member Institution: *
Do you approve of this application? *

Yes No
Reason(Optional)
Eligibility Certification *

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
Verification: *

I certify that all of the information contained in this application is complete and correct and that I am a US citizen and I meet all of the eligibility requirements for this form.
Applicant Signature: *

First Name Last Name
Date *

Month Day Year

Campus Director
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 Signature: *

First Name Last Name
Date *

Month Day Year

Advisor Approval:
Signatures below certify that the PI’s institution approves of the matching funds commitment indicated above and acknowledges an understanding that if this proposal is awarded, the PI’s institution will need to enter into a sub-contract between itself and the University of Hartford before any NASA CT Space Grant Consortium funds can be disbursed.
Please Enter any acknowledgements, concerns, or requirements for your approval:
Advisor Signature: *

First Name Last Name
Date: *

Month Day Year

Office of Sponsored Programs
Office of Sponsored Programs Signature: *

First Name Last Name
Date: *

Month Day Year

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Student - Faculty Research Grant - Researcher Application

Student Researcher Information:

Faculty Researcher Information

Grant Verification Form:

Please preview the form and press "Submit"