Wellness Seed Grants Application Page

Wellness Seed Grants

Project Information

Proposed Project Title *

Proposed Project Start Date *

Proposed Project End Date *

Applicant Contact Information

My Name *

My Email *

My UNID *

My Department *

My Phone Number *

My Mailing Address *

Advisor Contact Information

Name *

Email *

UNID *

Department *

Phone Number *

Responsible Department Information

Your responsible department is the department housing your project and/or managing your grant funds. Your grant will be transferred to this group following approval of your project.

Responsible Department *

Responsible Department Administrator Name *

Responsible Department Administrator Email *

Chartfield for Fund Transfer: (BU-ORG-FUND-ACT-ACC-A/U) *

Project Advisors & Collaborators

Please identify all team members, project advisors, collaborators, and involved university departments. Collaborators are those who authorize space, structural changes, agree to maintenance, donate materials, provide matching funds, or provide other trade services.

Please include the name, role and email contact for each of the collaborators involved. *

Brief Project Description

Please describe your project in 100-words or less. Please include the number of people this project will positively impact. A more complete description should be included in the attached Project Proposal. *

Project Outcomes

Please describe measurable outcomes from your project and how/when you plan to assess project effectiveness. *