RISS2012 2013 ApplicationForm 20120920 8

							                            Research Infrastructure Support Services Program 2012-2013
                                                 Application Form
        Please do not exceed available space for each section. You may append additional documents if necessary.
Requested by                                                          Rank

Date (yyyy/mm/dd)                                                     Dept/Unit

Telephone                                                             Email

Title of activity/project                                             Your role in the activity/project


1. Description of the activity, plus a description of: (a) the link to the Faculty Strategic Plan; and (b) the importance to the Faculty,
profession, practice and/or communities.




2. Describe the scope/demands of the activity. Please provide details (e.g. how many conference participants expected; number of
articles/chapters included in publication).
 3. Provide an itemized list of and justification for resources needed. For each type of resource, include: (a) what is needed
 (what, how much, how long); (b) why it is needed (link to demands and scope of activity); and (c) precedents if applicable (e.g.,
 from past similar activities). If GAA time is requested, include details about the specific tasks to be performed. You are
 encouraged to consult Brigitte Gemme (brigitte.gemme@ubc.ca, 604-822-0353) to help you scope the request.




 4. Describe any resources available from other sources (e.g., your unit, an organization, etc.).




Department/Unit Head Approval – REQUIRED
 5. Please provide a brief statement indicating resources to be provided for this activity from your unit, and a rationale for your
 support for the faculty member’s involvement in this activity (in relation to his/her overall workload and career trajectory, to
 the needs of the unit/Faculty, etc.).




 6. Signatures

           _____________________________                                _____________________________
           Applicant’s Signature                                        Department/Unit Head Signature (required)




For Internal Use only:   Date received (yyyy/mm/dd) _______________