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Graduate Student Association
Central Connecticut State University
1615 Stanley Street
New Britain, CT 05060
860-832-1GSA_____________________________________________________________________________
_________________________________________________________________________________________
_

                          APPLYING FOR A CONFERENCE/RESEARCH GRANT

1) Obtain and fill out a Graduate Student Association Conference Travel & Research Grant Request Form.
        •   Forms can be obtained from the Graduate Studies Office, Barnard 102 or on the GSA website.
        •   Be sure to fill out the entire form.
        •   Attach any informative documents such as travel / lodging quotes, as well as registration materials and
            information.

2) Return form to the Graduate Studies office at least one week prior to a GSA Executive Board meeting. Dates of the
    meetings are on the bottom of this form.

3) Please be sure to include your e-mail address or phone number for questions that may arise during the review of your
   application.

4) The Vice President of Finance will contact you to discuss the approval status of your application by e-mail or phone.

5) Once money has been expended, you will need to pick up a reimbursement form from the Student
   Activities/Leadership Development Business Office, on the second floor of the Student Center. Fill out the form
   attaching all receipts from the conference and hand it in to Rosario Soares in the Student Leadership Office.

6) A check will be mailed to you based on the receipts submitted.

NOTES:
     •      Reimbursement for conference attendance is limited to the following items: travel, lodging, food allowance,
            registration, and presentation supplies.
        •   Graduate students are allowed three grants (any combination of research/conference) per graduate degree.
        •   Research grants may not exceed $500, and conference grants may not exceed $1000.
        •   The GSA looks to fund those grants that benefit graduate students in their program of study and the campus
            as a whole, not those requests which are personal in nature.


                                           Fall 2008 GSA Board Information:

                Jess Long, VP of Finance                         Alexandra Rossett, GSA President
                Mailbox 4542                                     Mailbox 4542
                CCSU                                             CCSU
                1615 Stanley Street                              1615 Stanley Street
                New Britain, CT 06050                            New Britain, CT 06050


                Executive Board Meeting Dates: October 15 / November 5th and 19th/ December10th
Graduate Student Association
Central Connecticut State University
1615 Stanley Street
New Britain, CT 05060
860-832-1GSA_____________________________________________________________________________
_________________________________________________________________________________________
_

                      CONFERENCE / RESEARCH GRANT APPLICATION
Date: ___________

Directions and explanation of funding process:
     1.    Complete this form. Please include all signatures, copies of presentation materials, thesis proposals, and any
         other materials appropriate to your request in order to justify your expenditure.
     2. Submit this form and all materials to the GSA Vice President of Finance at least one week prior to the GSA
         Executive Board meetings.
     3. Please allow at least 30 days from submission of application for approval.
     4. Reimbursement will occur after approval of funding requests.

Please complete the following information:

Name: Dean R Wentworth_________________________ Enrollment Status: [ X ] Part Time [ ] Full Time
Address: 57 Parker St A204_______________ City: Wallingford ____________________________
State: ___CT____ Zip Code: _06492____________ Home/Cell Phone: (203)_284-7841_____________________
Work Phone: (203) 887-2932______ Fax: (_____)______________________
E-mail Address: deanwentworth@somcast.net

Please check the type of grant you are applying for:
        [ ] Research Grant               [ x ] Conference Grant

Major: Educational Technology School: School of Education
Academic Advisor: Dr. Abed Signature of Advisor: ________________________
Reimbursement for conference attendance is limited to the following categories. Please indicate the amount requested for
the necessary categories.

Travel: $328 Lodging: $695 Registration: $145
Presentation Supplies: $_______________ Food: $196.00__ (based on documents per city)
TOTAL AMOUNT REQUESTED: $1000
**Please consult the website http://www.policyworks.gov to obtain the proper food per diem rate.

All grant applications require a detailed budget. Please attach a detailed budget to this form and return to the GSA Vice
President of Finance.

**Graduate Students are allowed a total of three grants (any combination of research/conference) per graduate degree.
Students must have a minimum Grade Point Average of 3.0 and must be matriculated into a graduate program.

Number of supporting documents attached: ______
Signature of Applicant: ____________________________________________ Date: ___________________
Graduate Student Association
Central Connecticut State University
1615 Stanley Street
New Britain, CT 05060
860-832-1GSA_____________________________________________________________________________
_________________________________________________________________________________________
_


                          CONFERENCE / RESEARCH GRANT CONTRACT

This contract is an agreement between the GSA Finance Committee and Dean Wentworth

        •   Individuals will submit a proposed grant to the GSA Finance Committee.
        •   The GSA allocates money to Graduate Students after review by the GSA Executive Board, based on the
            proposals. The funds must be used in the manner in which they were initially proposed.


I understand and agree to the above terms.

Name: (Please Print) _Dean Wentworth____________________________________
Signature: ______________________________________________
Date: __________________________________________________
Updated 10/22/08

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Gsa Grant Appl Updated Oct 08 By Gsa

  • 1. Graduate Student Association Central Connecticut State University 1615 Stanley Street New Britain, CT 05060 860-832-1GSA_____________________________________________________________________________ _________________________________________________________________________________________ _ APPLYING FOR A CONFERENCE/RESEARCH GRANT 1) Obtain and fill out a Graduate Student Association Conference Travel & Research Grant Request Form. • Forms can be obtained from the Graduate Studies Office, Barnard 102 or on the GSA website. • Be sure to fill out the entire form. • Attach any informative documents such as travel / lodging quotes, as well as registration materials and information. 2) Return form to the Graduate Studies office at least one week prior to a GSA Executive Board meeting. Dates of the meetings are on the bottom of this form. 3) Please be sure to include your e-mail address or phone number for questions that may arise during the review of your application. 4) The Vice President of Finance will contact you to discuss the approval status of your application by e-mail or phone. 5) Once money has been expended, you will need to pick up a reimbursement form from the Student Activities/Leadership Development Business Office, on the second floor of the Student Center. Fill out the form attaching all receipts from the conference and hand it in to Rosario Soares in the Student Leadership Office. 6) A check will be mailed to you based on the receipts submitted. NOTES: • Reimbursement for conference attendance is limited to the following items: travel, lodging, food allowance, registration, and presentation supplies. • Graduate students are allowed three grants (any combination of research/conference) per graduate degree. • Research grants may not exceed $500, and conference grants may not exceed $1000. • The GSA looks to fund those grants that benefit graduate students in their program of study and the campus as a whole, not those requests which are personal in nature. Fall 2008 GSA Board Information: Jess Long, VP of Finance Alexandra Rossett, GSA President Mailbox 4542 Mailbox 4542 CCSU CCSU 1615 Stanley Street 1615 Stanley Street New Britain, CT 06050 New Britain, CT 06050 Executive Board Meeting Dates: October 15 / November 5th and 19th/ December10th
  • 2. Graduate Student Association Central Connecticut State University 1615 Stanley Street New Britain, CT 05060 860-832-1GSA_____________________________________________________________________________ _________________________________________________________________________________________ _ CONFERENCE / RESEARCH GRANT APPLICATION Date: ___________ Directions and explanation of funding process: 1. Complete this form. Please include all signatures, copies of presentation materials, thesis proposals, and any other materials appropriate to your request in order to justify your expenditure. 2. Submit this form and all materials to the GSA Vice President of Finance at least one week prior to the GSA Executive Board meetings. 3. Please allow at least 30 days from submission of application for approval. 4. Reimbursement will occur after approval of funding requests. Please complete the following information: Name: Dean R Wentworth_________________________ Enrollment Status: [ X ] Part Time [ ] Full Time Address: 57 Parker St A204_______________ City: Wallingford ____________________________ State: ___CT____ Zip Code: _06492____________ Home/Cell Phone: (203)_284-7841_____________________ Work Phone: (203) 887-2932______ Fax: (_____)______________________ E-mail Address: deanwentworth@somcast.net Please check the type of grant you are applying for: [ ] Research Grant [ x ] Conference Grant Major: Educational Technology School: School of Education Academic Advisor: Dr. Abed Signature of Advisor: ________________________ Reimbursement for conference attendance is limited to the following categories. Please indicate the amount requested for the necessary categories. Travel: $328 Lodging: $695 Registration: $145 Presentation Supplies: $_______________ Food: $196.00__ (based on documents per city) TOTAL AMOUNT REQUESTED: $1000 **Please consult the website http://www.policyworks.gov to obtain the proper food per diem rate. All grant applications require a detailed budget. Please attach a detailed budget to this form and return to the GSA Vice President of Finance. **Graduate Students are allowed a total of three grants (any combination of research/conference) per graduate degree. Students must have a minimum Grade Point Average of 3.0 and must be matriculated into a graduate program. Number of supporting documents attached: ______
  • 3. Signature of Applicant: ____________________________________________ Date: ___________________ Graduate Student Association Central Connecticut State University 1615 Stanley Street New Britain, CT 05060 860-832-1GSA_____________________________________________________________________________ _________________________________________________________________________________________ _ CONFERENCE / RESEARCH GRANT CONTRACT This contract is an agreement between the GSA Finance Committee and Dean Wentworth • Individuals will submit a proposed grant to the GSA Finance Committee. • The GSA allocates money to Graduate Students after review by the GSA Executive Board, based on the proposals. The funds must be used in the manner in which they were initially proposed. I understand and agree to the above terms. Name: (Please Print) _Dean Wentworth____________________________________ Signature: ______________________________________________ Date: __________________________________________________