2017-18 Thesis Research Travel Grant Education & Budget Statement Name (Last, First): UMN Student ID: Email Address:

Current UMN Graduate Program: UMN Graduate GPA:

Term of Entry to Program *Date Prelims Passed (MM/YYYY): Anticipated Term of (e.g., Fall 2015): Written: Graduation Oral: (e.g., Spring 2020): *Enter anticipated date if not yet passed. Graduate Institution(s): Major/Degree Earned: Year: GPA: 1. 2. 3. Undergraduate Institution(s): Major/Degree Earned: Year: GPA: 1. 2. 3.

(Working) Title of Research Project: Abstract of Research Project (maximum 100 words, written for non-specialist):

Word count:

Location of Project: Beginning and ending dates of travel for this grant request: to Have you traveled to the research site in the past? Yes: No: If yes, indicate length of time and purpose: Budget Examples of Allowable Budget Items Examples of Unallowable Budget Items

 travel (airfare, hotel, per diem expenses  daily living expenses in area of residence (e.g., rent, food, outside area of residence) insurance)  fieldwork  travel to conferences  photocopying  tuition  human subjects payments  equipment (items that can be used after the research is complete, such as computers, tents, lab devices)  postage  stipend

 final thesis production  Requests to purchase specialized books will only be considered if the books are not readily available through the University Library or Library loan.

 Low priority is given to requests for payments to consultants or assistants.

Amount Budget Item Total Requested Provide clarification, justification, and/or basis for estimate of each individual budget item. Amount If budget includes subjects or other sampling techniques, give rationale for subject/sample from this Needed size. If budget includes travel, indicate time, location(s), and cost per day. Grant $ $

$ $

$ $

$ $

$ $

$ $

$ $

$ $ Total: $ Total: $

Domestic Thesis Research Grant maximum request is $2,500. International Thesis Research Grant maximum request is $5,000.

Do you have other funds available or are you seeking other funds for this project? Yes: No: If yes, list other support, available and/or pending. Available Support:

Pending Support: (include monetary amount potentially available and approximate notification date)

The applicant may voluntarily waive the right to inspect letters of recommendation, thus assuring recommenders that the letters will remain confidential. The applicant may decline to sign the waiver.

I waive my right to inspect letters of recommendation.

I do NOT waive my right to inspect letters of recommendation.

I certify that the above information is complete and accurate to the best of my knowledge and that I have attached all supporting documents requested in the instructions.

Applicant Signature: ______(Typed signature is acceptable)

GSFO 06/26/2017