Doctoral Dissertation Research Grant Program
Cover Sheet
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UNIVERSITY OF MASSACHUSETTS BOSTON
DOCTORAL DISSERTATION RESEARCH GRANT PROGRAM
I. APPLICATION COVER SHEET
Insert cursor in first grey box, enter information, tab to next grey box, continue through form. Questions? Email Laura.Hayman@umb.edu.
Doctoral Student:
Home Phone:
Campus Phone:
Student’s Department:
E-mail:
Student’s Doctoral Program:
Dissertation Committee Chairperson:
Title of doctoral dissertation (200 characters maximum):
Doctoral dissertation abstract (50 words maximum):
Is this doctoral dissertation project currently being considered by any other agency for support?
If Yes, provide details:
Yes
No
In the last four years, have you received financial support (e.g., department or college funds, extramural grants) for the research
activity for which you are submitting this grant application?
Yes
No
If Yes, briefly explain how the proposed use of funds in this request differs from the use of prior financial support
(attach extra sheet if necessary):
Form revised 9/29/15
Doctoral Dissertation Grant Program
Cover Sheet
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Does your doctoral dissertation research require any
of the following?
Yes
No
Signature of authorized official following review
Human subjects
Laboratory animals
Hazardous materials
Radioactive materials
Computing services
NOTE: If the student’s doctoral dissertation will involve research with human subjects (including survey respondents and
secondary data analysis), then the student must obtain and submit certification of completion of the required training in the
protection of human research subjects in addition to Institutional Review Board (IRB) approval. If the student’s doctoral
dissertation will involve research with laboratory animals, then the student and each member of the research team that works
with or has contact with laboratory animals must obtain and submit certification of completion of required training in the
protection of animal research subjects in addition to Institutional Animal Care and Use Committee approval. Call the IRB
Coordinator at 7-5374 for assistance.
Submit one copy by e-mail to Graduate.Studies@umb.edu. The Office of Graduate Studies is not responsible
for any proposal lost or delayed in transit.
For review committee use only:
Date of Action______________________________
Funding:
Full
Partial
Action:
Recommended
Amount: $___________
Award start date: ________________________ Award end date: _____________________________
Comments:
Not Recommended
Doctoral Dissertation Grant Program
Budget Sheet
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UNIVERSITY OF MASSACHUSETTS BOSTON
DOCTORAL DISSERTATION RESEARCH GRANT PROGRAM
II. BUDGET
Request only those items indispensable to the doctoral dissertation research and not available through one’s department or from other
funding sources. The accompanying budget narrative must explain each item requested on this budget form.
Budget Category
Amount (Round to nearest $)
1. Communication
a. Postage
b. Telephone and FAX
2. Printing, duplicating, and camera ready copying
3. Travel*
4. Other costs – itemized and justified in budget narrative
a. Technical or clerical assistance
b. Other** (attach extra sheet if necessary)
Total amount requested (not to exceed $5,000)
$0.00
*Travel must be in accordance with current university regulations. Travel expenses should be listed in the accompanying budget narrative separately
by trip with the destination, purpose, and cost of each indicated. Budget requests for travel to present the results of the doctoral dissertation research
at a professional meeting will not be considered. Budget requests for travel to accept awards at regional, national, or international conferences will
not be considered.
**Budget requests for general-purpose statistical analysis software available on campus for student use (e.g., SPSS, Nudist, Stata, Mathematica) will
not be considered.
If a grant is provided for this doctoral dissertation project, I agree to (a) submit a written final report of the results to the Office of the
Vice Provost for Research and Strategic Initiatives & Dean of Graduate Studies within three months of the grant expiration date; and
(b) acknowledge receipt of the funds in all documents, papers, and publications associated with the research supported by the grant
award. If it is not possible for me to complete the doctoral dissertation project, I agree to return any remaining funds.
Signature of student
Date
I have read the student’s proposal and acknowledge (a) the student’s ability to carry out the project if funded, and (b) the availability
of any departmental or unit support included in the student’s proposal and budget.
Signature of chairperson of the student’s dissertation committee
Date
Signature of GPD of the student’s doctoral program
Date
Signature of the student’s department chairperson
Date
Form revised 9/29/15