The Graduate School
Assigned Time for Research FY 2016
Application Cover Form**
PI Name:
PI SIUE Email:
Title:
Campus Box:
Department:
School/College:
Co-Investigator Name:
Co-I Department:
Co-Investigator Name:
Co-I Department:
** Applicants should submit a scanned copy of Pages 1-2 to pgraybi@siue.edu by Jan 16, 2015
Brief Description and Title of Project:
Requested Budget
Unit requests should outline the cost of a) call staff at semester rates and/or b) a 50%
G.A. position. Maximum of two (2) units allowed.
Fall 2015 one unit
$
Spring 2016 one unit
$
call staff
G.A.
call staff
G.A.
Fall 2015 one unit
$
Spring 2016 one unit
$
call staff
G.A
call staff
G.A
Fall 2015 two units
$
Spring 2016 two units
$
call staff
G.A.
call staff
G.A.
Total $ Request
$
Deadlines
January 16, 2015: Department Chairs submit applications plus Chair evaluations to
Deans. Applicants submit electronic copies of Pages 1 and 2 to pgraybi@siue.edu.
February 2, 2015: School/College Dean submits applications plus Dean evaluations to
the Graduate School.
Terms and Conditions
If funded, I agree to submit a final report to the Graduate School by October 1, 2016 and
a grant proposal for external funding by October 1, 2017.
Applicant Signature: __________________________________Date: ________________
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The Graduate School
Assigned Time for Research FY 2016
Application Cover Form**
Checklist for Application Packet (refer to website guidelines for further information)*:
Cover Pages
Timetable (1 page max)
Narrative
(no more than 5 double-spaced pages)
Curriculum Vitae
(no more than two [2] pages)
*Please check your package carefully, as incomplete or ineligible applications will be
returned without review.
Please check if this project involves any of the following:
Human Subjects
Biosafety Control
Animal Care
Hazardous Waste
Radiological Control
Review Process (please indicate which review panel should evaluate your proposal):
Panel 1: Life Sciences/Biomedical (includes Nursing, Pharmacy, and Dental Medicine)
Panel 2: Physical Sciences and Engineering
Panel 3: Social Sciences, Business, and Education
Panel 4: Arts and Humanities
Please indicate any disciplines or areas of expertise that may be useful in the review of
your project:
Reviewer Exclusion Request (Please indicate below anyone who might have a conflict of
interest or should otherwise be excluded from reviewing your proposal. You may also send
separately to Patience Graybill Condellone at pgraybi@siue.edu):
See Signature Lines (continued on next page).
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The Graduate School
Assigned Time for Research FY 2016
Application Cover Form**
Department Chair’s Evaluation (Return with Proposal to School/College Dean by 4:30 Jan.16)
Attach extra pages if necessary.
On a scale of 1 – 5 (1 = poor, 5 = outstanding), please provide a score for this application based
on the project’s potential to produce quality research that can lead to external funding. See
program guidelines at http://www.siue.edu/orp/internalgrants/assigned-time.shtml.
Score ____________
Comments:
If a course buyout is requested, I agree that I will work with the faculty member and, if needed,
the dean's office to identify a suitable course.
I certify that the faculty or staff member has obtained the terminal degree appropriate to the
profession and is a tenured or tenure-track faculty member or a staff member with a research
appointment and, therefore, eligible for this program.
Chair’s Signature: ________________________________________
Date: ______________
Dean’s Evaluation (Return with Proposal to Graduate School by 4:30 p.m. Feb. 2)
Attach extra pages if necessary.
On a scale of 1 – 5 (1 = poor, 5 = outstanding), please provide a score for this application based
on the project’s potential to produce quality research that can lead to external funding. See
program guidelines at http://www.siue.edu/orp/internalgrants/assigned-time.shtml.
Score ______________
Comments:
If a course buyout is requested, I agree that, if needed, I will work with the faculty member and
department to identify a suitable course.
I certify that the faculty or staff member has obtained the terminal degree appropriate to the
profession and is a tenured or tenure-track faculty member or a staff member with a research
appointment and, therefore, eligible for this program.
Dean’s Signature: _________________________________________
Date: ______________
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