Center for Race & Gender Undergraduate Grants - Student Form
Academic Year 2017-2018
FALL 2017: DUE Monday, October 9, 2017 by 3:00pm

Please read grant details carefully! Details can be found here: crg.berkeley.edu/student-grants/
For questions, please email rng2@berkeley.edu

Email address
Name
Current E-mail
Current Address
Permanent Address
Student ID #
Department(s)
Title of Project
Amount Requested
Faculty Mentor Name & E-mail
Please upload your proposal and budget as one PDF file
Required
If I am selected as a CRG Undergraduate Grant Recipient, I agree:
• To submit a brief midterm report of my progress to date.
• To submit a final report within two weeks of the end of the grant period containing:
1) an itemized expense report;
2) a statement of what was accomplished; and
3) the faculty mentor’s evaluation of the project (if applicable)
• To have my project description included on the CRG website and newsletter, FaultLines.
Electronic Signature & Date
Questions? Please email rng2@berkeley.edu
You can also come visit us at 642 or 634 Barrows Hall.
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