Application Form

Antoinette C. Bigel Endowment Fund

Student Application Form and Cover Page

NAME:

PROJECT TITLE:

ADDRESS (Address to which any award letter and check should be sent):

TELEPHONE NUMBER:

SOCIAL SECURITY NUMBER:

ANTHROPOLOGY STATUS:

______ ANTH Major    _____ ANTH Minor    ______ ARCH minor

______Other (please indicate): 

FACULTY ADVISOR:

Date of meeting with Faculty Advisor: ____________

OVERALL GRADE POINT AVERAGE: _________ 

GPA in Major: _________

Number of Credits in Anthropology (excluding the current semester): ___________

Semester/Year in which Methods (ANTH 301) or equivalent was taken:  ____________

FIELDWORK COURSE FOR WHICH THE GRANT IS REQUESTED:

Course Number: ______ Course Title:  _____________________________________

Semester: ___Fall  ___Spring  ___Summer ; Year ________

 WILL YOU BE WORKING WITH HUMAN SUBJECTS?    ____Yes   ____No

_______ I have reviewed the "student contract" information on the Dept website

_______ I plan to seek IRB approval

_______ I do not plan to seek IRB approval (please explain):  

ANTICIPATED DISSEMINATION PLAN: 

 

GRANT PROPOSAL: TO BE ATTACHED

Attach a proposal of no fewer than 500 words including:

  1. A Project Title
  2. A Description of the Project
  3. The Purpose(s) for which The Funds Will Be Used
  4. The Expected Outcomes of Your Project
  5. A Budget

Submit your completed application, electronically, to:  vedwann@mail.montclair.edu

Dr. Neeraj Vedwan, Antoinette C. Bigel Student Award Fund Chair

Awards will be announced by Dr. Vedwan.