BEAUMONT FACULTY DEVELOPMENT FUND Application for Support Cover Page 1. Name(s) _____________________________________ Banner ID _____________________ 2. Department _________________________________________________________________ Campus Address (Bldg.) __________________________________ Room _______________ Campus Phone _____________________________ e-mail address __________________ 3. Project Title ________________________________________________________________ ___________________________________________________________________________ 4. Dollar Amount Requested _________________________________ 5. Desired Begin Date ____________________________ End Date ______________________ 6. Specific BFDF objective(s) to be addressed by this proposal ___________________________ ____________________________________________________________________________ 7. Have you received a BFDF award for any purpose in the past five years? ( ) Yes ( ) No 8. Does this project involve: Human Subjects ( ) Yes ( ) No Use of Animals ( ) Yes ( ) No Biohazards ( ) Yes ( ) No Isotopes ( ) Yes ( ) No If YES to any of the above, include in your application the approval certification of the corresponding review committee or individual, or indicate date submitted to the appropriate committee for review. (NOTE: Research may not begin until this approval is received.) 9. Signatures: Applicant ___________________________________________ Department Chair _____________________________________ School or College Dean _________________________________ Beaumont Faculty Development Fund – 2016 Application Package Page 1 ABSTRACT Beaumont Faculty Development Fund – 2016 Application Package Page 2 NARRATIVE Background/Need and Significance Objectives Methodology Expected Outcomes Dissemination Plan for Results (for research applications)–OR–Continuation Plan after the Award Period Ends (for curriculum or professional development applications) Student Benefit – If student labor is proposed, explain how the student(s) will contribute to the project and benefit from working with the PD/PI. Literature Cited Beaumont Faculty Development Fund – 2016 Application Package Page 3 BUDGET AND JUSTIFICATION Item Cost Total Requested from the Beaumont Faculty Development Fund: Justification Beaumont Faculty Development Fund – 2016 Application Package Page 4 CURRICULUM VITA/BIOSKETCH Beaumont Faculty Development Fund – 2016 Application Package Page 5 CURRENT/PENDING SUPPORT Active Projects All fields are required. Include both internal (SLU) and external support. If not applicable, type “None” in the Amount field. Amount Project Role Performance Period PD/PI Name Time on Project [Source of Funding] [Brief Project Summary] [Source of Funding] [Brief Project Summary] [Source of Funding] [Brief Project Summary] Projects Pending Award Determination All fields are required. Include both internal (SLU) and external support. If not applicable, type “None” in the Amount field. Amount Project Role Performance Period PD/PI Name Time on Project [percentage] [Source of Funding] [Brief Project Summary] [Source of Funding] [Brief Project Summary] [Source of Funding] [Brief Project Summary] PREVIOUS SUPPORT FROM THE BEAUMONT FACULTY DEVELOPMENT FUND If not applicable, type “None” in the Amount field. If applicable, see Guidelines for additional requirements. Amount Project Role Performance Period PD/PI Name Time on Project [Source of Funding] [Brief Project Summary] Beaumont Faculty Development Fund – 2016 Application Package Page 6