ࡱ> -/,Y bjbjWW -&==],   $ |  :  V   P: Application McCann Student Academic Development Fund 2001-2002 (Please print) Name: __________________________________________________ Social Security Number: ___________________________ Currently enrolled as: Full-time Student ______________ Part-time Student ______________ Classification: Freshman ______ Sophomore ______ Junior ______ Senior ______ Graduate ______ Major: ___________________________ Major GPA: ________ Minor: ___________________________ Minor GPA: ________ Cumulative GPA: _________ Number of credit hours received at Texas Wesleyan University: _______________ Expected date of graduation: _______________ Please indicate the extent of your involvement (in years), any awards recognition received, and any offices held in each of the following areas. a. List leadership qualities demonstrated both in and out of the high school/university setting: List other activities (honorary organizations, religious groups, political organizations, civic groups, scouting, etc.) in which your participation made a difference to you or those around you. Title of Proposal: _______________________________________________________________________ Dates involved: ______________________ to: ____________________________ Note: Applications should be received as early as possible, prior to the proposed event for maximum consideration. If travel is involved, destination: __________________________________________________________ PROPOSAL: [Briefly describe the purpose of your proposal. Include (1) How this activity will enhance your education. (2) How this activity will help advance your career preparation. (3) how this activity will benefit Texas Wesleyan University. Please be specific. You may attach additional sheets if necessary.] REQUESTED FUNDS: OTHER SOURCES OF FUNDING: (If applicable) yes_____ no _____ If yes,amount committed:_____ Please itemize as follows: Department Name: ______________________________________________________ Transportation: ____________ Lodging: ____________ Meals: ____________ School Name: _________________________ Registration Fee: ___________ yes ____ no _____ If yes, amount committed: _____ Miscellaneous Costs: ________ Other Sources: ______________________________ TOTAL: ____________ yes _____ no _____If yes, amount committed: _____ Faculty /Administrative Endorsement: Letters of endorsement/recommendation are required from at least two faculty members, one of whom must be in the department of your major. Additional letters of support may be submitted as applicable to the proposal. These letters should be enclosed with this application. Names of Recommenders: Faculty: _______________________________ Title: _________________________ Faculty: _______________________________ Title: __________________________ Other: ________________________________ Title: __________________________ Deans Recommendation and Disposition: [Check appropriate box (es)] __ /_/ Funding from Schools account Amount Approved: ________________ Account Number ______________________ __ /_/ Denying request Reason(s) for denial: __ /_/ Submitting to Review Committee Please complete the following: ________________________________ _________________________ Deans Signature Date Review Committee Action (if applicable): If approving request, please complete the following: Amount Approved: _______________ Account Number: ________________ _______________________________ _______________________________ Chairs Signature Date Provost Endorsement and Disposition: ________________________________ ______________________________ Provosts Signature Date A written report will be required at the completion of each activity. This report is due no later than one month after the end date stated in the proposal. Complete funding will not be awarded until this report is provided Final Report Received: _______________ Date ?W 4;HOY`jq}O_|ae % c i l r  ! . 8 D T n   & , 2 5 : T Z #?FfnCJ56>*CJ$`?AQ;O`q_Ne  & F@&$?AQ;O`q_Ne              ! # % ` 1 t  Z ?Ibxz|~ ~ "Hd              ! # % ` 1 t   Z ?Ibxz|~#2Ix I#Hhi5CJ6CJ6CJ>*5  ~ "HH!+0P/ =!"#$%) [<@<Normal 1$ddCJhmH nH <A@<Default Paragraph Font:O:Definition Term >O>Definition Listh(O( Definition6*O*H1$@& 5CJ0KH$&O&H2$@&5CJ$&O&H3$@&5CJ"O"H4$@&5&O&H5$@&5CJ&O&H6$@&5CJ.O.Address 60O0 Blockquote hhOCITE6$O$CODE CJOJQJ$X@$Emphasis6(U@( Hyperlink>*B*8V@8FollowedHyperlink>*B* 0O0Keyboard5CJOJQJfOf Preformatted0  # ~= z9!v% CJOJQJZOZz-Bottom of Form!$1$$d<CJOJQJhmH nH TOT z-Top of Form"$1$&d<CJOJQJhmH nH $O1$SampleOJQJ W@A Strong50OQ0 Typewriter CJOJQJ$Oa$Variable6,Oq, HTML Markup<B*"O"Comment< &   H  u +3`c Mary Anne Clark8C:\_Webpages\txwespag\biology\macclark\McCann\McCann.docMary Anne Clark1C:\_Webpages\txwespag\biology\macclark\McCann.doch,f@..p.@ .......p.@ .....hho(. ʧh,fdʧ0.@x @GzTimes New Roman5Symbol3& zArial?5 zCourier New"@h5a5a B3 ?Y2d. 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