BioGrads Award Request Form March 1, 2015 –February 28, 2016 Name E-mail address Please submit this award request and any other required documentation (see below) and questions to Ashish Gupta [email protected]. Purpose: BioGrads awards are provided to its members to defray the cost of conducting research and attending meetings. Eligibility • BioGrads Members who have attended ½ of the BioGrads Meetings for the year prior to applying Ex: If Clyde applies for an award March 13, 2010, then he must have attended ½ the meetings from March 1, 2009-March 1, 2010 • Members who have sold notes/kits 3 times since their last award and in the previous year prior to applying Ex: Using Clyde again, he must have sold notes at least three times from March 1, 2009- March 1, 2010, but if he received an award on December 14, 2009, he must have sold notes an additional three times in the past year to apply again in March. • Research or travel must occur during current BioGrad fiscal year (March 1, 2015 – February 28, 2016) and only 1 award allowed per fiscal year. Travel Research Please submit the following: Please submit the following: 1. Attending a meeting: A. If presenting, please submit a copy of your 1. A 150-350 word description of your abstract (you do not have to be first author). Include research. Include a summary of work to be location and date of meeting. done, dates, and location. B. If not presenting, please submit a 150-350 2. A budget with justification (see back for word explanation of why you are attending this meeting example) (give location, dates, relevance). 3. This form signed by both you and your 2. Proof of registration (e.g., copy of registration advisor confirmation) 3. Budget with justification (see back for example) 4. This form signed by both you and your advisor. **Awards can be applied for up to one month after travel or research activities. Requested funds must be applied directly to the costs associated with research or travel. Funds will be distributed directly to the student unless other arrangements are required. Requirements are subject to change without notice. Misappropriation of BioGrads funds will result in termination of further BioGrads funding. By my signature, I certify that funds will be used as stated in my application: Your signature Date By my signature, I certify that I have read over the application and find it true to the best of my knowledge: Major Professor’s Signature Date Rev 2015-03-24-SK Example Budget with Justification: Project title: Are mosquitoes attracted to vampires? Materials: $25 – 100,000 USDA bred mosquitoes $10 – mosquito net $100 – Consumable materials such as, but not limited to, Type O blood, disposable gloves, and anti-itch cream Living Expenses: $50 – for meals during stay at research facility Travel: $115 – Travel to Sunnydale, CA (where research will be conducted) Total funds requested: $300 OR Meeting: Vampire Health Society Registration fee: $100 Living expenses: $100-meals during stay Travel: $100-travel to Transylvania Total funds requested: $300 If you require a purchase order or some other arrangements, please contact Ashish Gupta. ************************************************************************************* Date Received by Treasurer Approved Type of Award Payment method: Check # PO #