Letter of Intent - Form and Submission

Application for: 
 Lewis University Faculty Scholar  
 Caterpillar Scholar

1. Applicant Information

*First Name:
*Last Name:
*Phone Number:
A value is required.Invalid format. 

*2. Co-investigators, collaborators, consultants, key personnel:

*3. Type of submission (choose one):

*4. Working title of project:

*5. Five keywords describing project:

*6. Summary addressing aims, approach (methodology) and significance (750 words - this is approximately one page single-spaced with 11-point font and 1 inch margins):

* 7. Describe anticipated outcomes of this project:

* 8. Describe how this work might promote a culture of inquiry at Lewis University through collaborations with others or involvement with students:

*9. For Lewis University Faculty Scholar Award, indicate semester of reassignment requested:
 Fall 6 hours
 Spring 6 hours
 Fall 3 hours and Spring 3 hours
 N/A (select this for Caterpillar awards)

*10. Check the box to indicate you have received Department Chair/Program Director Approval:
     Approval Date: 

Security Password (Please type the word ):

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