Name:
Address:
City: State: Zip Code:

Telephone/Cell Phone:

E-mail address:

Institutional affiliation (Include department. Leave blank if no affiliation.)

Academic status

Faculty
      Rank:
Graduate student (must include letter of support from advisor)
      Degree sought: Master’s Ph.D.
Principal advisor or thesis director:
Undergraduate student (must include letter of support from advisor)
Principal advisor or thesis director:
Independent scholar (must include letter of support from a colleague)

Education (degrees earned or in progress, years received or expected, and institutions)

Applicants may submit a résumé or CV if they wish.

Intended product
Thesis Dissertation Book Article or Paper
Other (describe below)

Title of project

Description of project (250-500 words)

List of relevant collections in Joyner Library’s Special Collections Department

Proposed dates of travel to East Carolina University (may be changed)

Estimate of expenses
Please provide details of airfare, automobile mileage (reimbursement @ 55 cents/mile), bus or rail expenses, local accommodations, meals, and parking. Note: reimbursement will be made based on state per diem rates (hotel=$63.75; breakfast=$7.50; lunch=$9.75; dinner=$16.75)

Amount of grant support requested (up to $1,000)

Supplementary documents
Applicant’s résumé or CV attached
Letter of support attached

Applicant’s Signature: Date:
(For electronic submission, the signature and date may be typed)

Deadline: Application must be received by March 31, 2009.