Tinker Nave Short-Term Field Research Grant Application – LACIS

Name*

Campus ID*

Department*

Program*

M.A.
PhD

If Other, please explain

Date of prelims, if applicable

Home Address*

Street Address Address Line 2 City State ZIP Code

Please include street name and number, city, state and zip code

Campus Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email Address*

Are you a U.S. citizen or permanent resident?*

Yes
No

If not, what is your visa status?

Country of citizenship (if not a U.S. citizen)

Country

Will you be on university payroll this summer?*

Yes
No

Project Information

Please tell us more about your research project.

Project Title*

Project Location*

Dates of Research*

Please provide dates as accurately as possible in the mm/dd format. If you can not provide specific dates, estimate the approximate number of days required to complete your project

Budget

In the lines below, please provide an estimate of the funds needed

International Travel*

Local Travel (in field)*

Food, Lodging and Miscellaneous*

Total*

Graduate Students Only

This section is to be filled out by Graduate Students only

Are you receiving any type of financial aid? (not including graduate assistantships)

Yes
No

If yes, please specify

Number of semesters of graduate work completed at UW-Madison

Letters of Recommendation & Language Reference:

Letters of Recommendation:*

Please provide the name, professional title/affiliation and email/phone of each of your recommenders here. You are required to submit TWO letters of recommendation. Please ask your recommenders to email their letters directly to Darcy Little at dmlittle@wisc.edu.

Language Reference:*

I will complete the "Language Proficiency Exam" (http://spanport.lss.wisc.edu/?q=node/143)
I am a Native Speaker
I am submitting a letter from a professor, former employer, etc. attesting to my language proficiency skills
previously studied, worked or volunteered abroad utilizing the language used in the country where I will be conducting field research (please submit short written explanation)
I have completed an extensive number of language courses (please submit list of courses)

Applicants are required to demonstrate proficiency in the native language of the country they will conducting field research in. Please select from one of these options to demonstrate your proficiency.

Attachments

Proposal Narrative*

Max of 4 double-spaced pages, 11-12 point font. This does not include the bibliography or budget. Files must be less than 4 MB. Allowed file types: pdf doc docx.

Unofficial UW-Madison transcripts*

Files must be less than 2 MB. Allowed file types: jpg pdf doc docx.

Additional Documents

Drop files here or

Files must be less than 2 MB. Allowed file types: gif jpg png pdf doc docx.