{"id":1010,"date":"2022-09-16T10:05:02","date_gmt":"2022-09-16T14:05:02","guid":{"rendered":"https:\/\/sites.temple.edu\/maub\/?page_id=1010"},"modified":"2025-02-11T12:44:25","modified_gmt":"2025-02-11T17:44:25","slug":"research-support","status":"publish","type":"page","link":"https:\/\/sites.temple.edu\/mahjb\/hub\/research-support\/","title":{"rendered":"MAHJB Student Request for Financial Support for Research"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_29_1'>\n                            \n                            <span id='input_29_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_29_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_29_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_29_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_29_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_29_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_29_8\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_8'>Temple Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_29_8' type='email' value='' class='medium'   placeholder='tuxxxxxx@temple.edu' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_29_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_29'>Title of research<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_29_29' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_33\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_33'>Date research will be completed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_33' id='input_29_33' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_29_33_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_29_33_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_29_33' class='gform_hidden' value='https:\/\/sites.temple.edu\/mahjb\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_29_4\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this research for your Master&#039;s thesis?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_4'>\n\t\t\t<div class='gchoice gchoice_29_4_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='Yes'  id='choice_29_4_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_4_0' id='label_29_4_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_4_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_4' type='radio' value='No'  id='choice_29_4_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_4_1' id='label_29_4_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_29_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you working with a CHJB faculty member who is serving as PI\/co-researcher on this project?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_9'>\n\t\t\t<div class='gchoice gchoice_29_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Yes'  id='choice_29_9_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_9_0' id='label_29_9_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='No'  id='choice_29_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_9_1' id='label_29_9_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_39\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_29_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Will this research require IRB approval?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_26'>\n\t\t\t<div class='gchoice gchoice_29_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='Yes'  id='choice_29_26_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_29_26\"   \/>\n\t\t\t\t\t<label for='choice_29_26_0' id='label_29_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='No'  id='choice_29_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_26_1' id='label_29_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_29_26'>If you are not sure, please reach out to your thesis advisor or PI before submitting this form.<p> You can also email irb@temple.edu with a brief description of your research and submit this form after you have received their reply. <\/div><\/fieldset><fieldset id=\"field_29_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Please indicate where you are in the IRB process.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_29_27'>Note: We can tentatively approve requests, but will not purchase any gift cards or requested items until IRB approval has been received.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_27'>\n\t\t\t<div class='gchoice gchoice_29_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='I have not yet submitted for IRB approval'  id='choice_29_27_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_29_27\"   \/>\n\t\t\t\t\t<label for='choice_29_27_0' id='label_29_27_0' class='gform-field-label gform-field-label--type-inline'>I have not yet submitted for IRB approval<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='I have submitted for IRB approval and am awaiting their review'  id='choice_29_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_27_1' id='label_29_27_1' class='gform-field-label gform-field-label--type-inline'>I have submitted for IRB approval and am awaiting their review<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='I have submitted and received IRB approval'  id='choice_29_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_27_2' id='label_29_27_2' class='gform-field-label gform-field-label--type-inline'>I have submitted and received IRB approval<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_28\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_28'>Please upload email\/other proof of your IRB approval<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='15728640' \/><input name='input_28' id='input_29_28' type='file' class='large' aria-describedby=\"gfield_upload_rules_29_28\" onchange='javascript:gformValidateFileSize( this, 15728640 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_29_28'>Max. file size: 15 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_29_28'><\/div> <\/div><\/div><div id=\"field_29_35\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_35'>Thesis advisor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_35' id='input_29_35' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select advisor<\/option><option value='Marilyn Baffoe-Bonnie' >Marilyn Baffoe-Bonnie<\/option><option value='Whitney Cabey' >Whitney Cabey<\/option><option value='Melanie Cosby' >Melanie Cosby<\/option><option value='Brendan Hart' >Brendan Hart<\/option><option value='Mary Beth Hays' >Mary Beth Hays<\/option><option value='Sharon Herring' >Sharon Herring<\/option><option value='Janet Lee' >Janet Lee<\/option><option value='Karen Meagher' >Karen Meagher<\/option><option value='Cornelius Pitts' >Cornelius Pitts<\/option><option value='Christy Santoro' >Christy Santoro<\/option><option value='Peter Simonsson' >Peter Simonsson<\/option><option value='Stephanie Spivack' >Stephanie Spivack<\/option><option value='Sam Stern' >Sam Stern<\/option><option value='Nicolle Strand' >Nicolle Strand<\/option><option value='Brian Tuohy' >Brian Tuohy<\/option><\/select><\/div><\/div><div id=\"field_29_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_36'>PI\/Co-researcher<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_29_36' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select PI\/co-researcher<\/option><option value='Marilyn Baffoe-Bonnie' >Marilyn Baffoe-Bonnie<\/option><option value='Whitney Cabey' >Whitney Cabey<\/option><option value='Melanie Cosby' >Melanie Cosby<\/option><option value='Brendan Hart' >Brendan Hart<\/option><option value='Mary Beth Hays' >Mary Beth Hays<\/option><option value='Sharon Herring' >Sharon Herring<\/option><option value='Janet Lee' >Janet Lee<\/option><option value='Karen Meagher' >Karen Meagher<\/option><option value='Cornelius Pitts' >Cornelius Pitts<\/option><option value='Christy Santoro' >Christy Santoro<\/option><option value='Peter Simonsson' >Peter Simonsson<\/option><option value='Stephanie Spivack' >Stephanie Spivack<\/option><option value='Sam Stern' >Sam Stern<\/option><option value='Nicolle Strand' >Nicolle Strand<\/option><option value='Brian Tuohy' >Brian Tuohy<\/option><\/select><\/div><\/div><div id=\"field_29_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_7'>Thesis Advisor Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_29_7'>Please note that your thesis advisor will receive a copy of your responses.<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_29_7' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_29_7\" \/>\n                        <\/div><\/div><div id=\"field_29_11\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_11'>Temple PI\/Co-researcher Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_29_11'>Please note that your PI\/co-researcher will receive a copy of your responses.<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_11' id='input_29_11' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_29_11\" \/>\n                        <\/div><\/div><div id=\"field_29_5\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_5'>What is the purpose of this research and how do you intend to share your research findings?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_5' id='input_29_5' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has your advisor reviewed and approved your research design?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_12'>\n\t\t\t<div class='gchoice gchoice_29_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Yes'  id='choice_29_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_12_0' id='label_29_12_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='No (please complete this form only after you have received approval)'  id='choice_29_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_12_1' id='label_29_12_1' class='gform-field-label gform-field-label--type-inline'>No (please complete this form only after you have received approval)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_29_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has your PI\/co-researcher reviewed and approved your research design?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_13'>\n\t\t\t<div class='gchoice gchoice_29_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_29_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_13_0' id='label_29_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No (please complete this form only after you have received approval)'  id='choice_29_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_13_1' id='label_29_13_1' class='gform-field-label gform-field-label--type-inline'>No (please complete this form only after you have received approval)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_14\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_14'>Describe your research question and primary research activities.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_29_14' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_18\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_18'>Amount requested with breakdown. (e.g., $x for gift cards\/incentives for participants, $x for equipment\/software)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_29_18' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does your request include gift cards?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_21'>\n\t\t\t<div class='gchoice gchoice_29_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Yes'  id='choice_29_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_21_0' id='label_29_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_29_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_21_1' id='label_29_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_37\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_37'>Please describe what you are requesting funds for and an estimated cost.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_29_37' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Please indicate which of the git card options you are requesting.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_29_22'>Merchant cards do not expire and are redeemable only at the selected merchant locations. These cards can be reloaded for repeat participants and can be deactivated if lost. <br><br> Eligible merchants are: \u2022 1800Flowers.com \u2022 Alamo Drafthouse Cinema \u2022 Amazon.com \u2022 AMC Theaters \u2022 Apple Gift Cards \u2022 Applebee&#8217;s \u2022 Bahama Breeze restaurant \u2022 Barnes &amp; Noble \u2022 Bass ProShop \u2022 Best Buy \u2022 Boston Market \u2022 Buffalo Wild Wings \u2022 Burger King \u2022 California Pizza Kitchen \u2022 Chilli&#8217;s \u2022 Chipotle \u2022 CVS \u2022 Domino&#8217;s \u2022 DoorDash \u2022 Dunkin Donuts \u2022 GameStop \u2022 EBAY \u2022 Google Play \u2022 Groupon \u2022 IHOP \u2022 Krispy Kreme \u2022 Red Lobster \u2022 Regal Cinemas \u2022 Staples \u2022 Starbucks \u2022 Target \u2022 Urber Eats \u2022 Uber \u2022 Walmart<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_22'>\n\t\t\t<div class='gchoice gchoice_29_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Physical gift cards to a specific vendor ($10 - $100)'  id='choice_29_22_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_29_22\"   \/>\n\t\t\t\t\t<label for='choice_29_22_0' id='label_29_22_0' class='gform-field-label gform-field-label--type-inline'>Physical gift cards to a specific vendor ($10 &#8211; $100)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Virtual gift cards to a specific vendor ($10 - $100)'  id='choice_29_22_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_22_1' id='label_29_22_1' class='gform-field-label gform-field-label--type-inline'>Virtual gift cards to a specific vendor ($10 &#8211; $100)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_31'>Vendor (must be on list above)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_29_31' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_30'>Who will be receiving the gift cards?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_29_30' type='text' value='' class='large'  aria-describedby=\"gfield_description_29_30\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_29_30'>Temple Purchasing will ask for a complete list of names and emails for all gift card recipients at the completion of your research. For initial approval purposes, please summarize who will receive gift cards (e.g. &#8216;community members who are interviewed about food insecurity&#8217; or &#8216;TU medical students in clinical rotations.&#8217;<\/div><\/div><div id=\"field_29_23\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_23'>Number of gift cards requested<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_23' id='input_29_23' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_29_24\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_24'>Dollar amount per gift card requested<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_29_24'>e.g. if you want 20 $10 gift cards ($200 total), please enter $10.<\/div><div class='ginput_container ginput_container_number'><input name='input_24' id='input_29_24' type='text' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_29_24\" \/><\/div><\/div><div id=\"field_29_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_19'>Tell us how this research is important and in line with the Center\u2019s mission of health  equity and to your education as a MA student.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_29_19' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_17\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I understand that submission of this request does not guarantee approval.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_29_17'><div class='gchoice gchoice_29_17_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_17.1' type='checkbox'  value='Yes, I understand'  id='choice_29_17_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_17_1' id='label_29_17_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_29_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I understand that, if approved, I will need to provide receipts for any items I purchase directly and all reimbursements will be applied to my student account.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_29_20'><div class='gchoice gchoice_29_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='Yes, I understand'  id='choice_29_20_1'   aria-describedby=\"gfield_description_29_20\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_29_20_1' id='label_29_20_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_29_20'>All payments to students (scholarship, award, stipend, fellowships, reimbursements, graduation gifts, prizes, etc.) must be processed through Student Financial Services since all are considered financial assistance per U.S. Department of Education regulations. As an educational institution, we at the University cannot award funding directly to our enrolled students via Accounts Payable. All payments to students that do not require service (compensation) must come through the Student Financial Services office for processing. Funding will go against billable charges (tuition, fees, dorm and meal plan) first and then be refunded if possible.<\/div><\/fieldset><fieldset id=\"field_29_25\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I understand that if my request for gift cards is approved, I will be responsible for managing the distribution and tracking of physical cards or electronic codes and communicating with participants how to use or redeem their gift cards. Temple University is unable to replace lost or stolen gift cards.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_29_25'><div class='gchoice gchoice_29_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='Yes, I understand'  id='choice_29_25_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_25_1' id='label_29_25_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_29_38'>We are unable to provide conference funding for research that has not been overseen by our faculty. Please email nicolle.strand@temple.edu and catherine.averill@temple.edu if you have any questions.<\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_29' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_29' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_29' id='gform_theme_29' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_29' id='gform_style_settings_29' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_29' value='1' \/>\n            <input type='hidden' 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