Psychology Department Funding Request Psychology Funding Application GENERAL INFORMATION: • Only Psychology majors qualify for funding • SIPS must be completed in the Psychology Department . • Non-SIP Funding request are to be pre-approved by the Psychology Department Chair . Name * RequiredK-ID number * RequiredOfficial ID number- Does NOT contain any lettersHOMETOWN/PERMANENT RESIDENCE Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email * Required ARE YOU A PSYCHOLOGY MAJOR * Required Yes No LIST OF PSYCHOLOGY CLASSES TAKEN (at K, abroad, or elsewhere) PSYC 210 Developmental Psychology PSYC 211 Adolescent Development PSYC 220 Health Psychology PSYC 226 Physiological Psychology PSYC 230 Psychology of Prejudice PSYC 238 Culture and Psychology of Arab-Muslim Societies PSYC 250 Social Psychology PSYC 265 Cognitive Science PSYC 270 Feminist Psychology of Women PSYC 275 Introduction to Psychopathology PSYC 280 Cognition PSYC 285 Psychology of Music PSYC 290 Animal Behavior with Lab PSYC 295 Psychology of the African American Experience PSYC 301 Intro to Research Methods in Psychology PSYC 330 Interviewing and Narrative Analysis With Lab PSYC 340 Cultural Psychology PSYC 390 Experimental Methods PSYC 410 Theories of Personality PSYC 411 Psychology and Law PSYC 415 Computational Neuroscience PSYC 420 Learning PSYC 422 Consciousness and Dreams PSYC 424 Psychopharmacology PSYC 450 Counseling Psychology: Theory and Practice PSYC 460 Social Development PSYC 465 Advanced Psychology of Sexuality PSYC 480 Psychology of Language and Mind OTHER Are you working with a Psychology Professor? Select All Dr. Batsell Dr. Boatwright Dr. Fletcher Dr. Gregg Dr. Hostetter Dr. Liu Dr. Mills Dr. Perry Dr. Tan NO, I am not working with a Psychology Professor Yes? Then select the Professors name. BRIEF DESCRIPTION OF YOUR FUNDING NEEDS * RequiredPlease tell us more about why you need funding for this. (400 words or less)INSTRUCTIONS FOR BUDGET • Be realistic and state your funding request clearly • You will need to attach a breakdown of these expenses. • You may be asked to submit your receipts upon your return to campus. Travel Expenses * Required Please include all air and/or ground travel, lodging and meals. Project Expenses * Required Please include all project materials, printing cost, food cost and venue cost. Other Expenses YOUR ANTICIPATED PROFESSIONAL EXPENSES $0.00 Budget SpreadsheetMax. file size: 5 MB.Please upload your budget spreadsheet with the breakdown of the above expenses.Stipends Please enter all numbers as negative numbers. Example: Stipends You received a stipend from another department. They awarded you $100, then you would enter -100 Other Grants/Scholarships (to be applied to this conference) Please enter all numbers as negative numbers. Example: Grants/Scholarships You received additional awarded money from another department or agency. They awarded you $100, then you would enter -100 Total amount requested $0.00 ADDITIONAL INFORMATIONDescribe your need for financial assistanceMax. file size: 5 MB.Please include any other sources of funding that are available to you. (200 words or less)UNOFFICIAL ACADEMIC TRANSCRIPTMax. file size: 5 MB. Δ
