By accepting a Kamber and Griffith Student Research Fellowship Grant Award, you agree to:

(1) complete the project you submitted in your proposal.
(2) not have additional employment that interferes with your ability to fully complete project.
(3) submit a 1-2 paragraph written reflection with at least 2 photos at the end of your research experience (by Aug 31st). If your project results in a written paper or presentation, you may be asked to submit that along with your written reflection. 
(4) present at the Summer Research mini-poster session on August 23rd (if you are in town at that time)
(5) not accept institutional funding (from your academic department, CIP, Arcus, etc.) for the same aspects of your project that are being funded by this award. 

Please complete the form below to indicate whether or not you agree with these terms, and to provide the necessary information to receive your funding.

Name(Required)

First Last

Preferred Name

Kalamazoo College Email(Required)

Student ID number(Required)

Please enter your six digit student ID number. This will be used to fill out the forms necessary for your stipend and reimbursements. If you are not already set up for direct deposit with the college, it is recommended that you do so (SOON!) at https://businessoffice.kzoo.edu/forms-2/.

Gender Identity(Required)

Do you identify as female? This is an eligibility requirement of the endowed fund.

Yes

No

STEM Project(Required)

Is your research project in a Science, Technology, Engineering or Mathematics (STEM) discipline? This is a eligibility requirement of the endowed fund.

Yes

No

Award Type(Required)

Please indicate the type of funding combination you were offered:

Stipend

Stipend + Reimbursable Expenses

Reimbursable Expenses/Billable Expenses

Reimbursable Expenses/Billable Expenses(Required)

Please indicate whether you will be submitting for reimbursement for your expenses or if the project organization will be billing Kalamazoo College directly.

Submitting for Reimbursement

Organization billing Kalamazoo College directly

Stipend + Reimbursement(Required)

Do you want to change the way your funds are distributed? (If relevant, this will have been referenced in your award letter)

Yes, keep the allocation as offered in the letter

No, I would like to change how my allocations are categorized (requires you to set up a meeting with Jessica Fowle)

Stipend Distribution Date(Required)

I understand that, in order to keep the award from affecting my financial aid package, I will not receive my stipend until June 17, 2024 (after the close of the academic year).

Yes

No

Funding Term 1(Required)

I agree to term 1: “I will complete the project I submitted in my proposal.”

Yes

No

Funding Term 2(Required)

I agree to term 2: “I do not have additional employment that interferes with my ability to fully complete project.”

Yes

No

Funding Term 3(Required)

I agree to term 3: “I will submit a 1-2 paragraph written reflection with at least 2 photos at the end of my research experience (by Aug 31st). If my project results in a written paper or presentation, I understand that I may be asked to submit that along with my written reflection.”

Yes

No

Funding Term 4(Required)

I agree to term 4: “If I am in town, I will present at the Summer Research mini-poster session on August 23rd.”

Yes

No

Funding Term 5(Required)

I agree to term 5: “I will not accept/have not accepted institutional funding (from my academic department, CIP, Arcus, etc.) for the same aspects of my project that are being funded by this award.”

Yes

No

Payment Distribution(Required)

How would you prefer to receive your stipend payment and/or reimbursement funds?

Pick up a physical check from campus

Direct Deposit

Have a physical check mailed to your home address

Address(Required)

Please enter the address (house/apt number, street name, city, state, zip) where you would like to have your stipend check mailed

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

International Student(Required)

Are you an international student? If you are an international student, all stipends and reimbursements will be REDUCED by the tax amount required by the IRS.

Yes

No

Project Description(Required)

Please enter a two-three sentence description of your research/project. This need not be technical; it is necessary for IRS purposes when paying research stipends, and the Kamber and Griffith Student Research Fellowship terms require us to send a brief summary of all award types.

Funding Accept/Decline(Required)

I agree to the five terms above and wish to accept the Kamber and Griffith Student Research Fellowship.

Yes

No

Signature(Required)

Comments

If you have any questions or comments, please enter them here, and Jessica Fowle will follow up as needed.

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