North Carolina Space Grant

First Name:
Last Name:
e-mail:	sample-applicant@example.com
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Address:
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Text messaging:	Send applications updates via text message
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Congressional District:	District 1 District 2 District 3 District 4 District 5 District 6 District 7 District 8 District 9 District 10 District 11 District 12 District 13 To find your Congressional District visit the House of Representatives Website. If your permanent home address is out of state please choose the congressional district for your school.
Verification of U.S. Citizenship:	I am a citizen of the United States of America

University:	What North Carolina institution of higher education will you be attending in the Fall?
Department:
Major:
Second Major/Minor:
Current Degree Track:	MA/MS     PhD
Expected Date of Graduation:

Title:	All proposals should be uploaded as one pdf file. Proposals must contain the following sections (incomplete applications will not be reviewed) - see announcement for detailed information: Title Page Description of Proposed Research Project Materials and Methods Tasks and a Timeline A Plan to Present Findings Data Management Plan Current CV Letter of support File Upload
	My research mentor has read and approved this project description and has agreed to supervise me while I conduct this research.
	I understand that my research mentor will ask me to report on my research activities at the end of the academic year.

for reporting purposes only

Gender:	Male Female
Ethnicity:	Hispanic or Latino Not Hispanic or Latino
Race:	American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Do not wish to report
Birthdate:
Person With Disability:	I do not have a disability I have a disability I choose not to disclose
Birthdate:
	How did you hear about the NC Space Grant/NC Sea Grant Graduate Research Fellowship Program?

If I receive this award I will:

General Requirements: Fellows are required to:

• Provide a photo and biographical information upon selection;
• Agree to abide by all reporting requests from North Carolina Space Grant and North Carolina Sea Grant;

Research Outcomes Products: Fellows are required to:

• Submit a Final Research Report that shall include a detailed summary of research results and an award impact statement. This information will be shared for review and use within NC Space Grant and/or NC Sea Grant;
• Present their findings at a meeting, conference, or other formal gathering of professional organization(s), association(s), etc. among peer researchers, policy-makers, or another relevant audience; and
• Respond to academic and employment follow-up surveys administered as required by the federal government.

Communications Products: Fellows are required to:

• Work with the NC Sea Grant and NC Space Grant communications team to develop and implement a plan to share their research experiences, including but not exclusively on social media, in print and on the NC Sea Grant and NC Space Grant web properties.
• Translate the results of their project into in a public forum or educational setting. Presentations that encourage interest in the research topic among the general public, policy-makers, and/or K-12 school students are encouraged; and
• Translate the results of their project into a blog post or article for a publication - such as Coastwatch magazine and the Space Grant news webpage.

I certify that all of the information contained in this application is complete and correct and that I meet all of the eligibility requirements stated in the program announcement.