University Honors Program

CENTRAL MICHIGAN

UNIVERSITY HONORS PROGRAM

Vending Money Application

Applicants must:

Ø  Be an undergraduate Honors student enrolled at CMU during the semester the application is submitted.

Ø  Be actively completing the Honors Protocol.

Ø  Complete a one-page termination report describing the results of the project to be filed with the Honors Program Office. This must be received by the Honors Program in order to be eligible for future funding.

Ø  Acknowledge Honors Program’s contribution at events, SRCEE, presentations, publications, conferences, etc.

Funding preference is given to those:

Ø  Who have not previously received funds from the Honors Program.

Ø  Whose proposed project is likely to lead to publication or presentation at state and/or national conferences.

Applicant Name: ______Student ID #______

Project Type:

□ Senior Project (attach a copy of your Senior Project Proposal) □ Research (attach a brief description)

□ Conference (attach a copy of Conference flyer/information) □ Other ______

Title of Project/Activity: ______

Name of Sponsoring Faculty member: ______

Project/Activity Summary:

Local Address: ______Phone: ______

Home Address: ______Phone: ______

CMU Email Address: _____Year: FR SO JR SR

Anticipated graduation date (semester and year): ______CMU GPA: ______

Budget: □ I have attached an itemized budget (see reverse side for sample budget)

Ø  Present an itemized budget of expected expenses associated with your project. Remember to retain original receipts and if seeking reimbursement for mileage, a detailed mileage log. The University requires original receipts for reimbursement (no exceptions).

Amount requested for reimbursement from the Honors Program: ______

Applicant’s Signature:______Date: ______

Honors Program Director’s Approval: ______Date: ______

Reimbursement Amount Approved: ______

Sample Budget

Student Name

Expenses:

Books: American Socrates $ 15

Yesterday and Today $ 23

Women for Philosophy Conference at University of Arizona:

Plane Fare $350

Hotel Rooms (2 nights @ $70) $140

Meals $100

Conference Registration Fee $ 70

Travel Expenses to Attend workshops on Socrates at MSU

3 trips (August 1, 5, and 8)

138 miles round trip x .36/mile x 3 trips $149

Total Projected Expenses: $847

Funding:

Honors Program $150

Philosophy Department $ 50

Women’s Studies $100

Club Sponsorship (PreLaw fraternity) $200

Student Contribution $347

Total Projected Funding: $847

CENTRAL MICHIGAN

UNIVERSITY HONORS PROGRAM

Vending Account Reimbursement Form

Please note: For reimbursement, you must provide the Honors Program Office with this completed form, including original receipts and/or a mileage log. A one-page termination report describing the results of the project must be filed with the Honors Program Office at the time this form and original receipts are turned in.

Applicant Name: ______Student ID # ______

Receipts:

Vendor/Store Name / Date / Reimbursable Amount / Non-Reimbursable Amount (i.e. expenses not related to the project cannot be reimbursed)
Receipt Totals:

Mileage:

Date / From (City) / To (City) / Round Trip Mileage / Mileage Costs (Honors Program use only)
Reimbursable Mileage Expense Totals:

Office Use:

□ Database Entry Date ______initials: ______□ Date submitted to Accounting ______

6-21-12