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

(1) attend a pre-award workshop.
(2) complete the project you submitted in your proposal.
(3) dedicate the number of hours to conducting this project as listed in your proposal. (i.e.: work full-time in the research lab of your mentor/fully engage with the research and/or travel required for data collection)
(4) submit a 1-2 paragraph written reflection with at least 2 photos at the end of the summer (by Aug 31st).
(5) present at the Summer Research mini-poster session in August, if in town.
(6)  not accept other institutional funding (from your academic department, CIP, Arcus, etc.) for this project unless your award letter specifically permits you to do so.

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/.

Funding Accept/Decline(Required)

I agree to the terms above and wish to accept the John ’69 and Karen Magerlein Endowed Fund for Physics Research.

Yes

No

Decline Confirmation(Required)

You have selected that you do not want to receive the offered award. Please confirm that this is correct. If you made the selection in error, please change your response to the previous question to “Yes” and continue to complete the form.

I confirm that I decline this funding offer

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 will attend a pre-award workshop.”

Yes

No

Funding Term 2(Required)

I agree to term 2: “I will complete the project I submitted in my proposal.”

Yes

No

Funding Term 3(Required)

I agree to term 3: “I will dedicate the number of hours to conducting this project as listed in my proposal.” (i.e.: work full-time in the research lab of my mentor/fully engage with the research and/or travel required for data collection)

Yes

No

Funding Term 4(Required)

I agree to term 4: “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 5(Required)

I agree to term 5: I will present at the Summer Research mini-poster session in August, if in town.

Yes

No

Funding Term 6(Required)

I agree to term 6: I will not accept other institutional funding (from your academic department, CIP, Arcus, etc.) for this project unless your award letter specifically permits me to do so.

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.

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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