Northern Virginia Chapter, Archeological Society of Virginia
APPLICATION FORM
(Please print or type)
DEADLINE: Fund applications will be accepted between January 2nd and September 15th.
If no applications are received by the deadline, no awards will be given. Any applications received after September 15th will be returned along with a letter encouraging reapplication in the following January.
Applicant Name:_____________________________________________________________
Phone: (d)_____________ (e) ______________ Email: ______________________________
Address: _______________________________________
_______________________________________________
_______________________________________________
Research Institution
Information:
Name:
_______________________________________________________________
(may include individual)
Organization Address:
____________________________________________________
____________________________________________________
____________________________________________________
Web site: ____________________________________________
Date(s) of research: ____________________________________
Total estimated cost of research $ ______
(may include: mailing/shipping, equipment, supplies, other items deemed necessary by the requestor)
The Chapter Officers retain the right to deny some charges, while awarding money from the Fund.
Please attach to this application not more than two double-spaced, typewritten pages explaining:
· Research issues;
· Scientific approach/objectives of this research effort(s);
· What you expect to learn from this research;
· How you will use the information.
Return the completed application to any Chapter officer or:
NoVa Chapter
Archeological Society of VA
2855 Annandale Road
Falls Church, VA 22042
Attn: Rubis-Fuller Research Fund
Signature: Date:
For Chapter Use Only:
Received by: ______________________________
Date: _______________
October 2009