Scholars in Service Application
Name (first and last)
Please briefly describe the purpose and nature of your project.
Project Start Date
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Project End Date
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Please provide the name and email address of your faculty or organization sponsor for the project.
Where will the project be completed? (city, state, and/or country)
Please describe the anticipated connections between your academic program(s) and the project.
Please describe how your project will serve to promote the vision and mission of the CCSJ. (These can be found on the Scholars in Service Info Sheet or at http://www.wku.edu/ccjs/)
Is this project fulfilling the requirements of a class?
Which class are you completing this project for?
For which term are you requesting funding?
Please estimate the total cost of your project or trip.
How much funding are you requesting through Scholars in Service?
If you have not already done so, please find the budget template on ________________, and use that template to create a basic budget outlining what the funds will be used for. Then upload your proposed budget in the form of an excel file here.
Have you applied for funds from any other department or outside provider?
Please list the organizations or departments from which you will be receiving funds as well as the amount of funding to be received by each organization. (This information will be used if scholarship matching is being considered.)
Is your class, department or organization already requiring some form of reflection?
Please describe the nature of the reflection required by your department/organization.
I understand the requirements for a reflection to be completed at the end of the project, and agree to cooperating with the CCSJ in completing this reflection.
Please electronically sign and date the form before submitting it.
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