Honors College Academic Enrichment Fund - University Honors ...

PART 1: Personal InformationStudent Name: __________________ Person Number: __________ Email Address: ________@buffalo.eduClass Year(FR/SO/ETC): _______ Expected Graduation Date: _________Telephone: _________________Academic Discipline Affiliated with the Activity: _______________________________Activity: ____________________________ Location of Activity: ________________ Dates: ____________Total Amount of Money Being Requested: ______________PART 2: Impact Write a 3 to 4 page persuasive statement to support your funding request.1. Describe this experience and explain how it fits in with your academics, career goals, and/or overalleducational experience.2. How does this opportunity complement or enhance your classroom experience?3. Why should the Honors College support you in this endeavour?4. If the Honors College provides funding for your request, how will you share what you learned from thisopportunity with the Honors College or broader university community?PART 3: Indication of Support from Faculty Mentor or AdvisorApplications will not be considered without some kind of correspondence in either paper or electronic form from thefaculty advisor/mentor. In addition to having your faculty advisor/mentor sign off on this form to indicate their support ofyour funding request, applicants are encouraged to strengthen their application with a faculty letter of support.Name: ______________________________Department: __________________________Signature: ____________________________Title: _________________________________Institution: _____________________________Email: ________________________________PART 4: Budget FormPlease use this form or attach a spreadsheet that follows the same format and content included below.Section A: Summarize all project related expenses (including dollar estimates) you expect to incur as aresult of the project.Item Details (if applicable) Cost Funding Source (Ex. Self,Honors College, Other)AirBus, Train, Car, etc.Local Fares (Bus, Taxi)Conference FeeOther ConferenceFeesFoodLodgingThesis MaterialsOther(Funding from OtherSources)TOTAL CostsTotal Amount of Funding from other Sources………………………………Total Amount Requested from the Honors College………………………..ii