STUDENT AFFILIATE MONETARY SUPPORT APPLICATION

NOMINATION FORM | DEADLINE MARCH 15TH ANNUALLY | $500

In order to request student affiliate monetary support, please complete the application for funding below. Outline the need / project, including specific budgetary information, and the relevance to the Center for Character and Citizenship (CCC) mission. NOTE: 1) This support is only for current CCC Affiliates. 2) This support does NOT pay for tuition.

I am a current Graduate Affiliate of the CCC

Yes

No (If no, you are not eligible for this funding)

Name

First Name

Last Name

Email

Phone

(###)

###

####

Address

City

Zip Code

Country

What will the funds be used for? Be specific. Provide budget details.

Note: This funding does not support tuition expenses. Receipts will be required prior to approval of this support.

If applying for travel expenses, have you been accepted to present at a conference?

Yes

No (If no, this request may not be funded)

Is there anything else you would like to add?

A CCC staff member will be in touch with you after you submit the application. Please e-mail us at ccc@umsl.edu if you have any questions.

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