Stipend Application Form

Complete the form below to apply for an InTeGrate workshop stipend. To apply for a stipend for the partnership workshop on Teaching Oceanography, use the Cutting Edge stipend application form (opens in a new window). Stipends are awarded to applicants based on financial need. Click on SUBMIT to send this application. Be sure to hit the SUBMIT button before leaving this page or your information will be lost.

Stipend Application Deadlines

Engineering, Sustainability, and the Geosciences: January 7, 2013
Teaching Environmental Justice: Interdisciplinary Approaches: February 15, 2013
Geoscience and the 21st Century Workforce: February 22, 2013
Partnership Workshop: Teaching Oceanography: March 12, 2013.

Basic informationYour full name used for federal income tax information:

Your email address (same as used in the workshop application, if possible):

Your institution:

Workshop for which you are seeking funds:

Home addressWe will send the stipend award check to your home (not work) address, matching the address used for federal income tax information.
Residence street address:

City:

Select a State:

Zip Code:

BudgetEstimate of airfare cost:

Existing funds available to you (e.g., Department funds, Dean's office, your institution's Teaching and Learning Center):

Total funds requested:

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