PARTNERSHIP-IN-LEARNING APPLICATION
University of St. Thomas
Center for Faculty Development
Submit electronically to the Faculty Development Center (facdevctr@stthomas.edu) by 4:00 pm
on the deadline date.
Name:
UST ID number:
Department:
Email:
College/School:
Campus mailbox:
Submission Date:
Faculty status: _ Full Prof _ Assoc. Prof _ Asst. Prof
Tenure status: _ Tenured
_ On tenure track
_ Clinical
_ Not applicable
_ Adjunct
_ Other: __________
Date of Initial Tenure-track appointment at UST (if applicable):
Academic year of proposed work (Semester & Year):
Title of Proposed Project:
1. Student partner's name, class, major, email address, and ID #:
2. Please describe why this particular student is appropriate for this project.
3. Check type of partnership: _____ Teaching Partnership _____ Research Partnership
4. Term(s) when partnership will take place, including anticipated end date for this
partnership:
5. Please provide a brief description of Faculty Mentor's project on which the student will
be working, and how this partnership will promote the faculty member’s scholarly agenda.
6. How will the student partner contribute to the work of this project? What will her/his
specific roles and responsibilities be?
7. What routine preparation work is required of the student?
8. How will the mentor supervise and interact with the student partner?
9. List, and describe briefly, any previous experience the faculty mentor has had with
student partners or assistants.
10. What are the anticipated benefits of this partnership for the Faculty Mentor and for the
Student Partner.
Revised Form (7/20/12)
Grantee Agreements:
______ I agree to submit to the Faculty Development Committee (1) an evaluation of the partnership and
(2) an accounting of funds spent, within three months of the completion date of the partnership as
indicated above. I understand that the submission of this final report is a necessary condition for further
funding from Faculty Development. I also understand that I will be responsible for any overdraft of funds
awarded to this project.
______ I do not have any Final Reports due for previous Faculty Development grants. (Check with the
Center if you are uncertain.)
______ I understand that if my research will involve human subjects, I will be required to obtain approval
from UST's Institutional Review Board (IRB) before beginning the project. See the IRB Web site for
information: http://www.stthomas.edu/irb
Signature of Faculty Mentor:________________________________________
Date:_________________
Partnership-in-Learning Budget Form
1. Student stipend $_________ (no more than $1000 for a one semester partnership; $2000 for
a two semester partnership)
2. Other Expenses (up to $300) $__________ Please itemize below:
3. TOTAL FUNDING REQUEST $__________
Revised Form (7/20/12)