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GRACE ANN GEIBEL INSTITUTE - INTENT FORM
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Grace Ann Geibel Institute for Justice and Social Responsibility – Intent to Submit a Funding Proposal

Please submit the online form below to be considered for funding during the current funding cycle.  Before you begin, we recommend that you read “Tips for Submitting the Intent to Submit form.” If you would like to discuss your project before submitting this form, please contact Marilyn Coleman at mcoleman@carlow.edu.    

This form must be completed during one sitting; it is not currently configured to allow you to save and return later to complete it. We recommend that you print out the form and draft your answers in Microsoft Word, and then return to the form and copy and past your answers into the form fields. (Do not begin the form then navigate away from it; you may lose some of your information.) Microsoft Word also has a handy “word count” feature in the Tools menu that will allow you to fit your answers to the allowed word limits. You cannot save the form, so please print a copy for yourself before hitting “submit.”  Your completed form is delivered electronically via a special email account to the Geibel Institute. 

Section 1: Contact Info
Proposer Name:
Email:
Phone:
   
Section 2: Project Abstract  
Brief description of project goals, participants, and activities requiring funding support
(50-75 words):
   
Section 3: Project Parameters
Please identify key project limits.
Project Name:
Project Start Date:
Project End Date:
Target Population:
(whom it will help/affect)
Community Partners:
   
Section 4: Project Plan Outline
Major Project Tasks/Activities: (Limit to 3 tasks)
Task 1:
Task 2:
Task 3:
Expected Outcomes/Products: (What will the project produce? Limit to 3 items)
Outcome/Product 1:
Outcome/Product 2:
Outcome/Product 3:
   
Section 5: Relationship to Institute Mission: (check all that apply)
Women-centered
Challenges systemic oppression
Engages students
Engages other faculty/staff
Is Research
Is Education and/or service learning
Is Community outreach and/or collaboration
   
Section 6: Institute Support Requested
  Funding (specify amount): $
 Fund-seeking assistance:
(e.g. identifying sources, proposal development)
 Technical assistance:
(e.g. strategic plan, data entry, transcription, contacts)
Student support/assistance:
(e.g. lit review, data collection, mailing/copying)
Other:
   
Due Date (fall or spring):
   
 
   

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