EASTERN'MICHIGAN'
UNIV
ER
SITY''
Graduate'Studies'and'R
esearch'
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G RADUATE' STUDENT' RESEARCH' SUPPO RT'
FUND'
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Applic ation
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Please'print/type' your'
responses.
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Name:
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!Student
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Num ber!
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Mailing!
Address:!
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Street
!Address!! City!! State!!
Zip
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Email!
Address:
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Program
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of
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Study:
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!!D ep artment:
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D eg ree
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Sought
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!!Anticipated
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date
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of
!
graduation:
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Num ber
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of
!
credits
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for
!
which
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you
!
are
!
currently
!
enrolled:
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Research!Information!
Title!of!
Project:!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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! Dissertation!!!!!!!!!!!!!!!Thesis!
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Provide' the'following' information' on'a'separate' page'attached' to'this'application'
form.
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What!are!the!estimated! costs!for!w hich!funds! are!being!requested?!! Provide! an!itemized!budget!
and!
a!
brief!rationale! for!each!
item.
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!
Tota l
!
funding
!
requested
!!
$!!
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Provide! a!timeline! for!study!
completion.
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Attach! a!copy!of!the!study!
prospectu s
/
proposal
,!visual!portfo lio,! project!s ummar y,! or!
similar!
document! that!explains!the!proposed!
work.
!
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If!Human! Subjects! approval! is!needed!and!has !been!granted,! please!submit!copy!of!acceptance.!! !
A!
copy!of!approval! must!be!submitted! to!the!Graduate! School!before!funds!can!be!
released.
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Applicant:!
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D ate: !
! !
Si gnature
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Graduate! Advisor :! ! !
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! !
D ate: !
! !
Si gnature
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Print
!Last!
Name
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Retu rn!application! and!attachments! to!the!Graduate! School,!200!Boone! Hall,!Ypsilanti,! MI!!48197.!!
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! 10/12
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