Research Incentive Request Form
A. Department Contact Information
1. Name:
2. Staff Number:
3. Department:
4. School:
B. Nature of the program
1. Description of the research/Journal/program/event/Book/ Patent/ Design patent/
Copyright
2. Purpose:
3. Expected outcome:
4. Benefits to MAAUN mission/vision/ranking
C. Collaborations
National
International
D. Authorship
Single
Joint
Names and affiliations of Authors
i. ____________________________________________________
ii. ____________________________________________________
iii. ____________________________________________________
iv. ____________________________________________________
v. ____________________________________________________
vi. ____________________________________________________
vii. ____________________________________________________
viii. ____________________________________________________
ix. ____________________________________________________
x. ____________________________________________________
E. Financial/Monetary plan details
Time frame:________________ To:_________________________
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F. Recommendations
1. Chair
______________________ _________________________ __________________
Name Signature Date
2. Dean
______________________ _________________________ _____________
Name Signature Date
G. University Research Committee
Chairperson URC
______________________ _________________________ _________________
Name Signature Date
H. Approvals
President
______________________ _________________________ __________________
Name Signature Date
Founder
______________________ _________________________ __________________
Name Signature Date
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