Living Laboratory Applied Research Application- Student

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First Name *

Last Name *

Affiliation *

Undergraduate student

Graduate student

Extension Student

Other:

Department *

Email *

Phone *

Project type *

Class project

Masters project

Dissertation project

Student Organization Project

Other:

What group or class is this project for? *

What faculty member are you working with? (if applicable) *

Number of group members (including yourself) *

Project Title *

Project Summary (500 words max) *

Is your project related to the Sustainable LA Grand Challenge? *

for details see grandchallenges.ucla.edu

Yes

Do you live in UCLA Housing? *

Yes

If yes where? (If no, write N/A) *

What buildings or areas of campus would be involved in your project? *

Will you need access to building interiors? (If so which ones) *

What is the timeline of your project? *

Are there costs involved in your project? *

Yes

If there is a cost involved, have you secured funding? From where and how much? *

Do you plan to survey or interview other students or UCLA faculty or staff? If yes, please describe how you plan to collect data and how would you access people. If no put "N/A" *

Is there anything else you would like us to know about the project? *

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