MAUB Student Request for Financial Support for Research Student Request for Financial Support for Research Name(Required) First Last Temple Email(Required) Is this research for your Master's thesis?(Required) Yes No Will this research require IRB approval?(Required) Yes No If you are not sure, please reach out to your thesis advisor or PI before submitting this form. You can also email irb@temple.edu with a brief description of your research and submit this form after you have received their reply. Please indicate where you are in the IRB process.(Required)Note: We can tentatively approve requests, but will not purchase any gift cards or requested items until IRB approval has been received. I have not yet submitted for IRB approval I have submitted for IRB approval and am awaiting their review I have submitted and received IRB approval Please upload email/other proof of your IRB approval(Required)Max. file size: 15 MB.Are you working with a Temple or TUHS faculty member who is serving as PI/co-researcher on this project?(Required) Yes No Thesis Advisor Name(Required) First Last Thesis Advisor Email(Required)Please note that your thesis advisor will receive a copy of your responses. Temple PI/Co-researcher Name(Required) First Last Temple PI/Co-researcher Email(Required)Please note that your PI/co-researcher will receive a copy of your responses. What is the purpose of this research and how do you intend to share your research findings?(Required)Has your advisor reviewed and approved your research design?(Required) Yes No (please complete this form only after you have received approval) Has your PI/co-researcher reviewed and approved your research design?(Required) Yes No (please complete this form only after you have received approval) Describe your research question and primary research activities.(Required)Amount requested with breakdown. (e.g., $x for gift cards/incentives for participants, $x for equipment/software)(Required)Does your request include gift cards?(Required) Yes No Please indicate which of the git card options you are requesting(Required)The Digital Visa Reward Codes are digital reward cards with a two-step redemption process. The end recipient has 3 months to register the token code and 6 months from date of card registration to redeem the digital Visa Reward Card, once the token code is registered. Digital Visa Cards can be redeemed online only. Hard copy gift cards have expiration dates and some have purchase fees. Digital Visa Gift Cards Hard Copy Gift Cards in $10, $25, and $50 amounts; Electronic Amazon Gift Cards in $10, $15, $20, $35, and $50 amounts Number of gift cards requested(Required)Dollar amount per gift card requested(Required)e.g. if you want 20 $10 gift cards ($200 total), please enter $10.Tell us how this research is important and in line with the Center’s mission of health equity and to your education as a MAUB student.(Required)I understand that submission of this request does not guarantee approval.(Required) Yes, I understand 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.(Required) Yes, I understand 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.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.(Required) Yes, I understand