Application Form NCUR

Name of Primary Student Researcher

Primary Student's Email

Name(s) of Other Student Researcher(s) (type "NONE" if there are no other students)

Name of Faculty Research/Creative Activity Mentor

Mentor's Email

Title of Presentation

Research/Creative Activity Discipline

BHSU IRB, IBC, or IACUC # (type "NONE" if this study does not require)

Is this presentation oral or a poster?

Abstract (250-450 words required)

I certify that: My project is at or near completion and the abstract accurately represents my findings. All required IRB, IACUC and Biosafety approvals have been received.

If my project is accepted for NCUR and I receive funding, I agree to:
- Complete my project before departure
- Make a trial presentation to my faculty advisor before departure
- Present my paper/project at NCUR and attend other sessions
- All required IRB, IACUC and Biosafety approvals have been received
- Give presentation at Black Hills Research Symposium (BHRS)
- Represent BHSU in a professional and responsible manner

Signature