Application
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
APPLICATION FORM
Name of Applicant:_______________________________________________________
Address for correspondence: ________________________________________________
________________________________________________________________
________________________________________________________________
Daytime Telephone Number: ________________________________________________
Mobile Phone Number, if preferred: ________________________________________________
E-Mail Address: _______________________________________________________
Date of Birth: ____________________________________________________________
Educational Institution: ___________________________________________________
Address (if different from above): ____________________________________________
___________________________________________________________________
___________________________________________________________________
Graduate Supervisor of the Applicant: _______________________________________________
Address: ________________________________________________________________
________________________________________________________________
Daytime Telephone Number: _________________________________________________
E-Mail Address: ________________________________________________________
Title of the Project: _______________________________________________________
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Duration of the Project: ___________________________________________________
Location of the Project: ___________________________________________________
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
APPLICANT’S CURRICULUM VITAE
Name: _________________________________________________________________
Undergraduate Education:
Institution: ______________________________________________________________
Degree and Date Conferred: ________________________________________________
Major/Minor: ____________________________________________________________
Graduate Education:
Institution: ______________________________________________________________
Department: ____________________________________________________________
Thesis Advisor: __________________________________________________________
Degree and Date Expected: _________________________________________________
Title of Thesis Research: ___________________________________________________
Additional Graduate or Undergraduate Education, if any:
Institution: ______________________________________________________________
Department: _____________________________________________________________
Description: _____________________________________________________________
Awards within the Past 3 Years: _____________________________________________
_________________________________________________________________
_________________________________________________________________
List of your Publications (Use an attachment, if necessary):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
ABSTRACT OF THE PROJECT:
Do not exceed 200 words. Please use the narrative form.
Applicant’s Name: ______________________________________________________
Title of Project: _______________________________________________________
_______________________________________________________
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
PROJECT DESCRIPTION
(Do not exceed 3 pages):
Describe the Project, and include:
- The overall objectives of the Project
- Your role in the project
- The significance of your participation in the project (if you are participating in a project led by others)
- The significance or expected impact of the overall project (Note: Your project will be reviewed by a team of individuals with a broad range of expertise, so placing your project in a context of broader significance will be of interest to those outside your discipline.)
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
BUDGET
(Note: Most awards range from one to several thousand dollars)
Please provide a budget breakdown with costs listed per item
Attach a list of current support (include source and amount)
Attach a list of pending grants (include source and amount)
EXPLORERS CLUB WASHINGTON GROUP
EXPLORATION AND FIELD RESEARCH GRANTS PROGRAM
RECOMMENDATION FORM
Name of Applicant: _____________________________________________
Referee: _______________________________________________________
Address: _______________________________________________________
_______________________________________________________
_______________________________________________________
Signature: ______________________________Date: __________________
Telephone Number: ______________________________________________
E-mail: ________________________________________________________
Please include information on how long you have known the applicant and in what capacity; how the proposed project will further the goals of increasing knowledge in the areas of exploration and field research and how participation in the proposed project will contribute to the development of the applicant’s career or make a contribution to the field. Attach additional pages as needed.
Please send the recommendation letter to ecwggrantsprogram17@gmail.com Please ensure that the student’s name is in the subject line.
SUBMISSION DEADLINE: February 3, 2017