Valparaiso University - Committee on Creative Work and Research
Undergraduate Research Grant

Application Cover Sheet



Name of Applicant ________________________________________________________________

Faculty Member _____   Student _____   (please check one)


Faculty:   Years of Full-time Service to the University____________________________________

Academic Rank _______________________________    Highest Degree Attained _____________

College ________________________________ Department ______________________________

Office Phone and E-mail __________________________ Application Date___________________

Student:   Year in School________ College________________Department___________________

School Address:__________________________________________________________________

Phone and E-mail_________________________________ Application Date__________________

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Project Title _____________________________________________________________________

Total funds requested from CWR $_____________________

Chair/dean signature for part-time faculty:___________________________ Date_______________
                                                                             (signature required)
Faculty sponsor's signature for students:____________________________ Date_______________
                                                                             (signature required)
Signature of Applicant:_________________________________________ Date ______________
                                                                            (signature required)

Grant applications should be submitted to the Office of the Provost (Rm. 107) in Kretzmann Hall

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THIS SECTION IS TO BE COMPLETED BY THE OFFICE OF THE PROVOST

Date received ______________ Application complete upon receipt?   ____ Yes ____ No