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Non-Affiliates Proposal Application

Proposal Submission/Funding requests



This form must be completed for any funding requests such as travel, programs, scholarships,
supplies, and materials, etc., or for any proposal ideals.


Required fields are indicated by *

Last name * :
 

First name * :
 

Address :
 

City :
 

State :
 

Zip :
 

Email address * :
 

Phone number * :
 

Fax number :
 

Title of proposal or funding request:
 

Category :
Pre-College/Informal Education
Higher Education
Research
General Public
 

Abstract (150 word maximum) :
 

Start date :
 

Ending date :
 

Amount of funding requested :
 

Date funding required :
 

Check payable to :
 

Relevance to the National Aeronautics and Space Administration (NASA) :
 

Timeline (give start date, end date and details on milestones) :
 

Personnel (list all individuals working on the project and a brief description of their duties) :
 

Budget and/or resources needed (include details of cost and list any funding from other sources) :
 

Additional Required Information :
 

Numbers of students graduate * :
 

Numbers of students undergraduate * :
 

Numbers of K-12 * :
 

What are the grade levels ? (K-12 only) * :
 

Number of teacher participants ? * :
 

Number of parents involved in project (K-12 only) * :
 

Number of administrators involved in project *:
 

Number of others involved in project * :
 

Will this program be evaluated or involve tracking. If so, please explain * :
 

Please confirm by signing below -
• The Georgia Space Grant Consortium will be included in all publicity as a sponsor or co-sponsor of your program.
• A complete accounting of expenditures will be given to the GSGC
For a copy of the GSGC official logo, email mroberts@gatech.edu .
 

Initials * :

Date * :
 
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