Name: ________________________________________________
(Please Type or Print; Last Name First)
SSN: _________________________ Date of Birth: ____________
Applicant's Citizenship : United States -or- ______________ (Country)
Mailing Address: _________________________________________
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Permanent Address (if different from above): ___________________
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Home Phone: _________________ E-mail: ____________________
Work Phone: _________________ Fax: ______________________
Education:
Institution Degree
Date Awarded
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Employment: Current Position or Occupation: _______________________________
Institutional Affiliation, if any: _______________________________
Product of research: __ Book __ Ph.D. Dissertation __ MA Thesis __ Article __ Other ___
Title of Research Project: __________________________________
________________________________________________________
Research proposal:
Please attach the following:
Additional requirement: two letters of reference should be mailed directly to the Harry S. Truman Library Institute by persons familiar with your academic or scholarly work (including where appropriate, the project advisor). Reference letters must be in before the announced deadline.
Name of archivist contacted at Truman Library: _________________________________
Estimated funds needed:
Total amount requested: $________
Advance Airfare Rate: $__________ Car: $______ (mileage: 48.5 ¢ per mile
for those driving in)
Number of days @ $75 per diem: $_____ Bus: $ _______ (Greyhound, Trailways)
Photocopying fees (up to $100): $____
Estimated dates at Truman Library: From: ___________ to: ______________
Applicant's Signature: ___________________ Date: __________
***** LIBRARY USE ONLY BELOW THIS LINE ********
Received: ____________ Archivist's Evaluation and Comment: Days/Feet ______
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|
Mail or Fax application to: Grants Administrator |
Archivist questions should be directed to: Randy Sowell or David Clark. |
Last updated: 8/04