Student Research Project Proposal Form
STEM COLLEGIAN CENTER
Prince George's Community College, Largo, MD 20774
Phone: (301) 341 – 3086
PART I.
Mr.
FAX: (301) 386 – 7529
Email: STEMCollegianCenter@pgcc.edu
COLLEGIAN INFORMATION.
COMPLETED BY STUDENT (PRINT OR TYPE)
Ms.
Mrs.
NAME:
LAST
FIRST
M.I.
HOME ADDRESS:
CITY:
STATE:
ZIP CODE:
COUNTY
DATE OF BIRTH
HOME PHONE: (_____)
WORK PHONE: (_____)
MOBILE PHONE: (_____)
EMAIL:
RESEARCH PERIOD (Start and End Dates):
PROJECT TITLE:
GROUP PROJECT:
Yes
No
If yes, indicate group member(s) names. (Note that Part I of the Proposal form must be received
from each member of the group.)
Name:
Name:
Name:
Name:
STEM Collegian Center Research Proposal Form (Rev. 8/05)
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PART II. PROJECT INFORMATION
COMPLETED BY STUDENT(S) (TYPE AND ATTACH AS
SEPARTE SHEETS)
PROJECT DESCRIPTION:
-
This description must be typed in a 12 point font and double spaced.
The description should be a maximum of 300 words.
This description is an overview of the project being proposed. This must include the
expected start and completion dates for the project.
EXPECTED PROJECT OUTCOMES:
-
Explain, in one or two paragraphs the results expected from the research activity and
how the project relates to your academic interests.
For example, if your project should produce something concrete, such as a new
software application, you should describe this application, what it is, how it will be
used, and who will use it. If your project is an experiment, you should describe what
you expect to discover from the experiment.
BUDGET:
Each student will receive a stipend of $400 dollars upon successful completion of
their project and submission of the summary report (see below).
In addition, there is a budget of up to $80 for supplies or materials needed to
complete the project. Please indicate, as precisely as possible:
o what supplies and materials you require,
o why they are required for this project,
o how much each item should cost, and
o from where these supplies should be obtained. The College will then order these
supplies for you.
SUMMARY REPORT: (to be submitted upon completion of project)
-
This report may be satisfied in one of the following ways:
o A paper or poster presentation for a conference or symposium based upon your
research project will serve as the summary report.
o If your project does not produce a conference or symposium paper or
presentation, you MUST prepare a 2 page (minimum) report which describes the
project, your activities, your results and conclusions, and any recommendations
for further research.
STEM Collegian Center Research Proposal Form (Rev. 8/05)
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To receive capstone project credit for this activity, I understand that my responsibilities are to:
 Complete this project proposal form and have it approved by the supervising research
mentor with which I will be working
 Obtain prior approval for this project from the Coordinator or other authorized
representative of the STEM Collegian Center
 Complete the project as described on this application
 Meet periodically, as agreed on this application, with the research mentor to document
project progress
 Submit a summary report upon completion of the project
 Participate in follow up surveys (by phone, mail, or email) on this project and the
research mentor’s participation in the project (Your responses will help improve
opportunities for future students.)
I, the undersigned, understand that if I do not fulfill these responsibilities, I will not receive
credit for participation in this activity. I understand that the project is not approved for funding
until this form is signed by an authorized representative of the STEM Collegian Center. I
understand that neither the STEM Collegian Center nor Prince George's Community College
assumes any liability for any accident or injury incurred while participating in this research
project.
STEM Collegian Center Student’s Signature
Date
Submit two copies of the completed and signed proposal forms and supporting documents
(prior to commencing project) and summary report (upon completion of project) to:
Dr. John McClure, Research Coordinator
STEM Collegian Center
Chesapeake Hall Room 100
Prince George's Community College
301 Largo Road
Largo, MD 20774
STEM Collegian Center Research Proposal Form (Rev. 8/05)
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PART III. RESEARCH MENTOR INFORMATION
COMPLETED BY RESEARCH MENTOR (PRINT OR TYPE)
Dr.
Mr.
Ms.
Mrs.
NAME:
LAST
FIRST
M.I.
TITLE:
ORGANIZATION:
ORGANIZATION ADDRESS:
CITY:
STATE:
ZIP CODE:
COUNTY
EMAIL:
WORK PHONE: (_____)
ALTERNATE PHONE: (_____)
PERIODIC MEETING SCHEDULE: (To document progress/participation)
Daily
Weekly
Biweekly
Monthly
I understand that as the supervisor and authorized representative of my organization, I agree to:
 Coordinate the completion of the research project, as described on this proposal
 Meet periodically, as agreed on this application, with the student to document progress in
the research project
 Review and sign the summary report (prior to student submission)
 Participate in follow up surveys (by phone, mail, or email) on this activity and the
student’s participation in the activity (Your responses will help improve opportunities for
future students.)
I, the undersigned, agree to provide certification that the student has carried out the agreed-upon
research project. I understand that if I do not provide this certification, the student will not
receive funding for participation and completion of this research project. I understand that the
project is not approved for funding until this form is signed by an authorized representative of
the STEM Collegian Center. I understand that neither the STEM Collegian Center nor Prince
George's Community College assumes any liability for any accident or injury incurred while
participating in this research project.
Research Mentor Signature
STEM Collegian Center Research Proposal Form (Rev. 8/05)
Date
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