By accepting a John ’69 and Karen Magerlein Endowed Fund for Physics Grant Award, you agree to:

(1) complete the project you submitted in your proposal.
(2) dedicate my primary focus this summer to conducting this project.” (i.e.: work full-time in the research lab of your mentor/fully engage with the research and/or travel required for data collection)
(3) submit a 1-2 paragraph written reflection with at least 2 photos at the end of the summer (by Aug 31st). I will submit the SIP or final paper to be shared with the donor. This is a requirement of the grant.
(4) present at the Summer Research mini-poster session in August, if in town.
(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/.

Award Type(Required)

Please indicate the type of funding combination you were offered:

Stipend

Stipend + Reimbursable Expenses

Reimbursable Expenses/Billable Expenses

Physics Project(Required)

Are you conducting a Physics research project? This is a eligibility requirement of the endowed fund.

Yes

No

Funding Term 1(Required)

I agree to term 1: “I do not have additional employment that interferes with my ability to fully complete project.”

Yes

No

Funding Term 2(Required)

I agree to term 2: “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

Funding Term 3(Required)

I agree to term 3: “I understand that the Business Office may take 10-14 days to process my funding request.”

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. This need not be technical; it is necessary for IRS purposes when paying research stipends, and the funder requires us to send a brief summary of all award types.

Funding Accept/Decline(Required)

I agree to the terms above and wish to accept the Harry T. Garland Endowed SIP Fund.

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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