SCHOOL OF HUMANITIES AND SCIENCES
SUMMER SCHOLARS PROGRAM
FACULTY MENTOR FORM
The H&S Summer Scholars Program provides paid opportunities for H&S students in the creative arts,
humanities, social sciences, and mathematics, to work directly with a member of the H&S faculty on a
collaborative project (research, scholarship, or creative work).
Faculty Mentors will receive a stipend of $1250 for their participation in this Program, regardless of the
number of students they are mentoring. Faculty cannot combine this stipend with summer funding from
the Center for Faculty Excellence, or with other summer funding, to support collaborative work with
students.
Please consult the application guidelines before submitting this form; they are available for download at
http://www.ithaca.edu/wpm_preview/site/awards_and_honor_soc/docs/summscholars/summschl
rguide/
COMPLETE THIS FORM IN WORD – NOTE THAT THE TEXT BOXES WILL EXPAND AS YOU TYPE. WE
WILL NOT ACCEPT HANDWRITTEN HARD COPIES.
Section I: General Information
Faculty mentor name
Faculty department
E-mail
Phone
H&S student applicant name
H&S student major(s)
Project title:
Brief summary of the project (limit to one paragraph)
Type of project: (choose the one that best matches your project):
Creative Work (studio art, theatrical production, creative writing)
Field-Based Study (interview, participant-observation, action research)
Research Project (surveys, statistical analysis, coding)
Scholarship (archival, text-based)
Will this project take place:
on campus/in the local area
out of the area – location:
If you answered "out of the area," will you and the
Summer Scholar be together in this location?
Yes
No
Does this project involve human subjects?
Yes
No
If Yes, be sure that the student submits the project for
approval by the Human Subjects Review Board at IC
before the start of the project in the summer:
http://www.ithaca.edu/sponsored-research/irb/
Will the project continue into the academic
year?
Yes
No
Section II: Student and Project Details
How long and in what capacity have you known the applicant?
How would you rate this student compared to other students in your department?
in the top 10%
in the top 25%
in the top 50%
What skills and experience does the student applicant have that qualify him/her to participate in
the project? In your answer, please include your assessment of the applicant's overall academic performance,
reliability, and maturity.
Briefly describe the role you will play as the Faculty Mentor and the role that the Summer Scholar
will play in this project. In your response, please indicate whether this project is faculty-designed, with an
independent component for the student; or student-designed, with active collaboration by the faculty mentor.
Please also discuss how you plan to interact and collaborate with the Summer Scholar during the summer
experience.
How will participation in the project benefit the Summer Scholar?
How will you provide the Scholar with opportunities for structured reflection?
How will you evaluate the success of the Summer Scholar's work and the success of the summer
project? What role will the structured reflections play in your assessment of the success of the
summer experience?
Please save the completed form with a new file name, following this format: <StudentLastName>SummerScholar-Mentor-2016 (e.g., Smith-SummerScholarMentor-2016). Then submit this form as an
email attachment to hsadmin@ithaca.edu.
To be considered for the program, all materials (Student Application and Faculty Mentor form) must be
received by 4pm on Monday, February 15.
Thank you for your interest in participating in the H&S Summer Scholars Program as a
mentor to an H&S student.
form: 11/2015