UGRI Mentor Online Application

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UGRI MENTOR ONLINE APPLICATION


Please fill-in all spaces as accurately and completely as you can
. When you have finished, click the SUBMIT button below. Please click it only once. You should receive verification of receipt of your application after it has been sent. Thank you!

NOTE: All applications must be in student-mentor teams. The student and mentor application forms can be submitted separately, but each must clearly refer to the other.

Application Deadline:  March 13, 2009


Researcher's Name (no title, please):
Department or Institution:

Address:

City:

State:

ZIP code:

Phone Number (include area code):

E-mail Address:

Project Title:


Please give a one paragraph description of the proposed student project.



Please provide any optional supporting materials, such as bibliography or vitae, in this box. A maximum of one page typed-equivalent is allowed.



Is there a dollar amount match you can specify? (It is acceptable to include your time contribution which is
anticipated to be an in-kind match, equivalent to a minimum of 5% of your time).
 Please be specific
as this info is needed to meet NASA requirements.


If so, how much:

Please describe the actual work to be performed by the student, and estimate the number of hours per week, over two semesters, needed to complete the work.

Name of proposed undergraduate intern:

Please give a brief summary of the expected outcome of the work (presentations, publications, etc.) in which the student will be involved.

OPTIONAL

Please give the name, title, and brief description of the person who would directly supervise the student on a day-to-day basis (if different from yourself).

Name:
Title:

Brief description:

Please list any miscellaneous research expenses that may be needed to cover the cost of the student's participation in this project. Due to NASA budget cuts, we can only consider expense amounts of up to $200.  We ask that you both specify and justify them in advance.

Is this project connected with funding from other sources?

Is it possible that this project will have support from other sources?

Please state how your proposed project would benefit NASA, or otherwise overlap with NASA's wide-ranging interests.

Have you received previous Space Grant support?

If yes, please give: The name of the project; project year; the names of the students involved, and a summary of the outcome or results, including presentations and publications involving Space Grant students.

Would this project be appropriate for undergraduate research credit for part of the project if full funding is not available (e.g., three hours per week = one credit hour)?

Deadline:  March 13, 2009


For more information, please contact:

Kathleen Stigmon: Program Coordinator, NAU/NASA Spacegrant Program
Department of Physics and Astronomy
Northern Arizona University Box 6010
Flagstaff, AZ 86011-6010
(928) 523-8067

Updated on May 30, 2008 by Kathleen Stigmon.
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