GFG Request Form Requests must be submitted at least four weeks prior to the activity for which funding is being requested. GFG Request Form Name(Required) First Last Pronouns(Required) BU Email(Required) Phone(Required)BU ID(Required) School/College(Required) Note that the application is open only to Boston University students currently enrolled in an undergraduate degree program in the College of Arts and Sciences (CAS).Semester and Year of Graduation (Expected)(Required) Note that we cannot approve requests for activities that are scheduled to take place after your expected date of graduation. Major(s)(Required) Minor(s) Have you applied for support from this fund previously?(Required) Yes No Please describe the outcome of your previous request. If awarded funds, how much did you receive?(Required) What type of experiential learning are you requesting funding for?(Required) Applied coursework (e.g., project materials or travel related to a CAS course) Community engagement (e.g., service trip) Creative, innovative, or entrepreneurial projects (e.g., fees to support book publication) Internships (e.g., transportation to/from site) Fieldwork (e.g., travel, materials) Leadership (e.g., invited participation in leadership summit) Research (e.g., conference fees for research presentation) Study abroad/away (e.g., travel costs not covered by program fee) Other Short description of activity(Required) Is this activity offered through Boston University?(Required) Yes No Unsure Which office or department at BU is offering this activity?(Required) Name of non-BU organization offering the activity.(Required) Website of non-BU organization offering the activity.(Required) What course is the activity associated with?(Required) Please provide course number and title.Course instructor(Required) Are you receiving compensation for your internship?(Required) Yes No Other What is your rate of compensation?(Required) Please provide either hourly rate plus the number of hours you will be interning per week or total stipend amount.Is this fieldwork a required part of your degree program?(Required) Yes No Other Is your research mentored by a faculty member at BU?(Required) Yes No Other Name of research mentor(Required) Is your research funded by UROP?(Required) Yes No Other Is your research related to an honors thesis project?(Required) Yes No Other Did you apply for funding through the BU Study Abroad office?(Required) Yes No Other Please describe any funding you have received from BU Study Abroad.(Required) Documentation of your acceptance to participate in the experiential learning activity(Required)Max. file size: 100 MB.Examples of documentation include email inviting you to present your research at a conference; offer letter from internship site; or acceptance on Alternative Spring Break trip.What is the date (or date range) of the activity for which you are requesting funding?(Required) Requests should be submitted at least four weeks in advance of activity.What amount of funding are you requesting?(Required) Requests for more than $700 cannot be accommodated.Please provide a detailed summary of how you intend to use these funds, including itemized costs.(Required)If approved, how do you prefer to receive funds?(Required)To pay out of pocket and get reimbursedTo work with the office to pay up frontUnsurePlease describe the relevance of this experiential learning activity to your CAS coursework and future career goals.(Required)What skills and/or knowledge do you expect to gain from this activity? State your learning goals.(Required)Please describe other funding sources for this activity that you have investigated and/or applied for. If you have been approved for other support, provide the amount and source of that funding.(Required)Provide as much detail as possible about why you are making this request (i.e., your need for the funds). What would be the impact of receiving (or not receiving) funding?(Required)By what date do you need to know if your request has been approved?(Required) Attestation(Required) By checking this box, I attest the following1.) that all information I have provided in conjunction with this request is true and complete; 2.) that the experiential learning activity for which I am requesting funding meets the guidelines of the fund; 3.) that, if awarded funding, I will submit the required reflection about the experiential learning activity and what I learned from it.