LSAMP URE Participant Budget Proposal
LSAMP URE Participant Information
LSAMP URE Participant Name
*
First Name
Last Name
LSAMP URE Mentor Name
*
First Name
Last Name
Student ID #
*
Phone Number
*
-
Area Code
Phone Number
Student Email
*
example@student.cccs.edu
Research Question
*
Budget Breakdown
Supply and Equipment Costs:
*
Name of Item
Describe the Use/Purpose
Vendor/Link
Quantity Needed
Unit Cost
Total Cost
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
TOTAL AMOUNT REQUESTED
*
$0.00
Signature
*
Submit
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