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* 1. Student First Name

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* 2. Student Surname

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* 3. Student's Email Address

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* 4. Student Institution

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* 5. Mentor First Name

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* 6. Mentor Last Name

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* 7. Mentor's Email Address

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* 8. Mentor Institution

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* 9. Abstract (150-250 words) including: objective, methods, expected results and statement of significance

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* 10. How does the student's work contribute to diversity and inclusion? (150-250 words.  e.g., underrepresented minority researchers, research topics that include diversity and inclusion)

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* 11. Explain the student's role in the research (150-250 words)

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* 12. How has the research experience contributed to the student's long-term goals? (150-250 words)

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* 13. How will the award allow the student to participate more fully in research? (150-250 words)

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* 14. Please provide an itemized breakdown of the funds.  If the project will cost more than $400 (the maximum for the CUR award), please explain the source(s) of the remaining funds.

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* 15. If funds are being requested to attend a conference, please indicate what the student's class will be at the time of the conference.  If a fourth-year student, conference must be completed within 3 months of fall graduation or by June 15, 2022, for spring graduates.

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* 16. Please indicate membership status.  The student's mentor must be a CUR member, or the student's home institution must be a CUR institutional member.  (Access the Membership Directory)

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