ࡱ> NPM bjbj Faa4hPl.,f  "(Rh`ocKjiJ<  @    z:   Organization of Psychology Students Research Reimbursement Request Form You may be reimbursed up to $300 for items that are research related, including for your Research Project I, Research Project II, pre-doctoral dissertation, or dissertation project. Each doctoral student can be reimbursed up to five times during their graduate career and each masters level student can be reimbursed up to two times during their graduate career (reflecting one possible reimbursement per year). These can be accumulated over time (i.e. if you do not use a reimbursement in your first year, you still have five left). Reimbursement Request Deadlines: Fall Semester December 22nd Spring Semester May 15th *Applications received after the stated deadlines date will not be eligible. Reimbursement Request Forms received after the stated deadlines will not be eligible, and must be submitted the following semester. In the event that reimbursement requests exceed available funds, reimbursements will be determined by lottery. Reimbursements will be mailed to you after the end of each semester. OPS makes no judgment as to the quality or subject matter of projects. Reimbursements are granted based upon timely receipt of a completed application. To request reimbursement, please email  HYPERLINK "mailto:opsreimbursements@gmail.com" opsreimbursements@gmail.com with electronic copies of the completed and signed Application (Information Form and Expense Form) together with the additional documentation listed on the Information Form (see below). Eligible Expenses: Reimbursements will only be granted for those expenses incurred by the student, which have no value that survives the research project. Examples of eligible expenses that will be approved: mailing, participant reimbursement, and photocopying. Examples of ineligible expenses which will not be approved: WAIS kit or medical monitoring equipment. Please type or print neatly - illegible applications will not be considered Date Received: _________________________ OPS Representative: _________________________ OPS RESEARCH AWARD APPLICATION Information Form Name: _______________________________________________________ Local Address: ___________________________________________________________ Permanent Address: _______________________________________________________ Telephone: ____________________________ Cell Phone: ____________________________ E-mail Address: _____________________________________________________________ Program: _________________________________________________________ Class of: 20 ________ Professor: ____________________________________________________ Title of Project: _____________________________________________________________ Please include the following: Completed and signed Information Form A one-page description of the project Proof of IRB approval or equivalent Completed Expense Form signed and dated by student applicant and professor together with copies (do not include originals) of the receipts for the items listed in the form. I agree to provide OPS with a copy of all completed portions of my research project I, research project II, or dissertation. OPS has the right to reproduce my work on its website or other medium for inclusion in its Sponsored Projects section or for archival and promotional purposes so long as same are not for any commercial gain. I have read the foregoing application and attachments and affirm that all statements are true. ____________________________ _______ ____________________________ ______ Student Signature Date Professor Signature Date Print Name: __________________________ Print Name: _________________________ OPS RESEARCH AWARD APPLICATION Expense Form Name: _______________________________________________________ Local Address: ___________________________________________________________ Telephone: ____________________________ Cell Phone: ____________________________ Title of Project: ________________________________________________________ Item Purpose for Expense Cost For Official Approved Use Only Not Approved 1.      2.      3.      4.      5.      6.      ____________________________ _______ ____________________________ ______ Student Signature Date Professor Signature Date Print Name: __________________________ Print Name:__________________________     Updated 2018 #%HIJfjk} _ ` a û÷÷dzÎzsissh1wh,|6] h1wh,|hc.]h,|5H*h]h,|5H* h,|5 hh,|hh,|5hh,|5>* h,|5>*hbdh]h,|h,|5h,|hmh,|hmCJ,aJ,h,|h,|CJ,aJ,hhmCJ0hhmCJ0aJ(hhmCJ0aJ2)%IJ` a gd] `p^p`gdm p^p`gdm `gdbd `gd,| `p^p`gd,|gdm$a$gdm  # R U E F    7 8 S T Z s $&4tuֽֽֽ֤֙h]56CJ\]aJhm6CJ]aJ hm>*h,|hm5 h1whm h]5hh>kh]0Jjh]Uh]hm h1whbdh4RDh,|5h77h,|5h,| h77h,|hbd5%&DEUVWc)1<Hõұ{{{{w{hvihljhlU hm6]hhm5hhm5CJaJhm6CJ]aJhhmhh]5CJ]aJhh5CJ\]aJhm56CJ\]aJh]56CJ\]aJh]h]h]6CJ]aJ*%&EVW-. `0^`0gdmgdm$a$gd$a$gd]gd]:N9 &$d%d&d'd+D-D.M NOPQgd])*jk'bK `EƀSF)gdmK `EƀSF)gdmgdm 'KIJgbbbbbbbgdmK `EƀSF)gdmK `EƀSF)gdm PQ  XY :$Ifgdm d$Ifgdm `0^`0gdm Hgdmgdm `gdm `P^`Pgdm()23IJK`~kd$$Ifxr$ 84 xax $Ifgdm d$Ifgdm :$Ifgdm KNOPQRSTUVWXY d$Ifgdm :$Ifgdm $Ifgdm YZ[^_`PD;;; $Ifgdm d$Ifgdmkd$$Ifxr$ 8 (4 xaxp(`abcdefghi d$Ifgdm :$Ifgdm ijknopPD;;; $Ifgdm d$Ifgdmkd$$Ifxr$ 8 (4 xaxp(pqrstuvwxy d$Ifgdm :$Ifgdm yz{~PD;;; $Ifgdm d$Ifgdmkd$$Ifxr$ 8 (4 xaxp( d$Ifgdm :$Ifgdm PD;;; $Ifgdm d$Ifgdmkdw$$Ifxr$ 8 (4 xaxp( d$Ifgdm :$Ifgdm PD;;; $Ifgdm d$Ifgdmkdm$$Ifxr$ 8 (4 xaxp( d$Ifgdm :$Ifgdm PPKK:1 `gdm `P^`Pgdmgdmkdc$$Ifxr$ 8 (4 xaxp(PQ `P^`Pgdmgdm;0P:pm/ =!"#$% Dp50P/ =!"#$% Dp;0P:pm/ =!"#v$%v Dp$$Ifx!vh#v#v #v8#v#v:V x55 5855/ 44 xax$$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp($$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp($$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp($$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp($$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp($$Ifx!vh#v#v #v8#v#v:V x (55 5855/ 44 xaxp(6666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH L`L nuNormal1$7$8$H$CJ_HaJmH sH tH DA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List DOD nuLevel 1 & F0@&^`0H@H ?F Balloon TextCJOJQJ^JaJ4@4 VHeader  !4 "4 VFooter  !6U`16 ] Hyperlink >*B*phcPK!pO[Content_Types].xmlj0Eжr(΢]yl#!MB;.n̨̽\A1&ҫ QWKvUbOX#&1`RT9<l#$>r `С-;c=1g'}ʅ$I1Ê9cY<;*v7'aE\h>=,*8;*4?±ԉoAߤ>82*<")QHxK |]Zz)ӁMSm@\&>!7;ɱʋ3װ1OC5VD Xa?p S4[NS28;Y[꫙,T1|n;+/ʕj\\,E:! t4.T̡ e1 }; [z^pl@ok0e g@GGHPXNT,مde|*YdT\Y䀰+(T7$ow2缂#G֛ʥ?q NK-/M,WgxFV/FQⷶO&ecx\QLW@H!+{[|{!KAi `cm2iU|Y+ ި [[vxrNE3pmR =Y04,!&0+WC܃@oOS2'Sٮ05$ɤ]pm3Ft GɄ-!y"ӉV . `עv,O.%вKasSƭvMz`3{9+e@eՔLy7W_XtlPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-!pO[Content_Types].xmlPK-!֧6 -_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!!Z!theme/theme/theme1.xmlPK-! ѐ'( theme/theme/_rels/themeManager.xml.relsPK]# F=FtF   'KY`ipyP !"7SX8@0(   B S  ?EFR:::))))))))a0)ؕA1)Xo2)^`3)@4)Kn5)h|6)`L7) AutoList2  bdvic6:q,|]vl]m@\|x@UnknowncbeguestG*Ax Times New Roman5Symbol3 *Cx Arial5 *[`)TahomaA$BCambria Math"@hmJGa  x2483QHP ?W%2 $Organization of Psychology Students Preferred CustomerCaitlin Sleight  Oh+'0 4@ d p |'(Organization of Psychology Students Preferred Customer Normal.dotmCaitlin Sleight4Microsoft Macintosh Word@F#@V%)@` ՜.+,D՜.+,h$ hp  'Dell Computer Corporation  %Organization of Psychology Students Title 8@ _PID_HLINKS'A@d#mailto:opsreimbursements@gmail.com  !"#%&'()*+-./0123456789:;<>?@ABCDFGHIJKLORoot Entry FެcQData $1Table,* WordDocumentFSummaryInformation(=DocumentSummaryInformation8ECompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8