Educational Enhancement Awards – Funding Request Form Educational Enhancement Awards - Funding Request Form Heading link Copy link FUNDING REQUEST FORMS & GUIDELINES The UICOMP Alumni Council considers funding requests that further the Council's mission: To enhance and support educational and humanitarian endeavors for students, residents, faculty, and alumni of the University of Illinois College of Medicine Peoria. Applicants should review the guidelines and criteria below before completing the application form(s). GUIDELINES & CRITERIA Requests should fall within UICOMP Alumni Council’s mission and receive approval of the requester’s supervising dean (for student projects, approval of the Asst. Dean for Student Affairs). Students seeking funding for attendance at an educational program should complete both forms (Funding Request Form & Robert A. Flinn, MD, Educational Enhancement Award Form), and submit a one-page explanation. Reimbursements must conform to University policy. Requests must be made at least 10 business days prior to the proposed project, event or travel. The Council encourages requesters to secure matching funding from other sources (i.e., from sponsoring department, hospital, etc.) prior to submission of the request. The requester shall be notified of the Council’s decision via email. The Council will review requests as necessary or at their regularly scheduled meetings. Individual students may be granted one Robert A. Flinn Educational Enhancement Award within any given academic year. The Council reserves the right to make multiple awards or to deny any request. Students must be registered for courses in the term for which the travel takes place, with the exception of students who are on an approved leave of absence for research reasons, if the travel request relates directly to their research work. FUNDING REQUEST FORMDate: MM slash DD slash YYYY Contact Person:(Required) Contact Phone Number/Email:(Required) Project/Request Title: Please Indicate Classification of Request: Scholarly Activity Program Support *Student Support to attend scholarly events (also must complete the Flinn Form below) Equipment Education Other Other (Description, if selected) If selecting "other", please define what type of request is being made.Amount Requested ($): Other Matching Funds Secured or Requested:Amount ($): From: Amount ($): From: Description:Please describe in detail how the program or event matches the mission of UICOMP Alumni Council.Itemized Budget:Submitted by: Submission Date: MM slash DD slash YYYY Robert A. Flinn, MD, Educational Enhancement Award Sponsored by the UICOMP Alumni Council APPLICATION FORM The UICOMP Alumni Council provides awards to reimburse a medical student for attendance at an educational program. Reimbursements will be made to cover a portion of registration fees, travel expenses, lodging, and meals during the scholarly meeting. CRITERIA: Student must be in good academic standing. Applications are reviewed for: Clarity of presentation, rationale (demonstrated interest), financial need, appropriateness of attendance at meeting, and overall academic performance. Events must be a state or nationally recognized scholarly meeting, part of an educational/mission event that is appropriate for student attendance or must have CME approval. Students should seek a faculty review, endorsement or sponsor. To be considered, applications must be submitted prior to travel. Direct questions to the Office of Advancement and Community Relations 309-680-8613 or adv-peoria@uic.edu. STUDENTS WHO RECEIVE FUNDING ARE EXPECTED TO: Maintain receipts of expenditures for reimbursement. Provide a summary sheet of information learned from the scholarly meeting they attended. Present a five to 10 minute summary at a UICOMP Alumni Council meeting.Student Name: Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email: Phone:Name of project and scholarly meeting you wish to attend:Attach meeting documentation (i.e. brochure, registration form, etc.)Max. file size: 15 MB.Date(s) of meeting: Location of meeting: Approximate Itemized Travel Budget:Attach a one-page document explaining how attending this meeting will enhance your medical education.Max. file size: 15 MB.Electronic submissions should be sent to adv-peoria@uic.edu