CNSI Propel Industry Internships programPropel Awards Application

CNSI Propel Industry Internships program

Propel Awards Application

Supplemental funding for already-secured internships.

Priority will be given to first-time applicants.

Email*

First Name*

Last Name*

Academic Status*

Select or enter value

Major*

Department*

Advisor First Name*

Advisor Last Name*

Is this your first time applying for a CNSI Propel Grant?*

Yes

Start date for the internship*

End date for the internship*

Institute/Company Name*

Company Location*

City. Note that internships must be in CA to qualify.

What is the scope of your internship?*

What is the scope of this opportunity?*

What is your motivation for this opportunity?*

Funding amount requested*

List the expenses for this opportunity*

List any other funding you are receiving or seeking for these expenses*

Source/Amount

Participant Demographics

CNSI is collecting this information from program participants and applicants to assess whether our activities are fairly reaching and benefiting everyone, regardless of demographic category; to ensure that those in underrepresented groups have the same knowledge of and access to CNSI programs; and to assess their involvement. Submission of this information is voluntary and is not a precondition for participation.

I prefer not to supply demographic information

Status in US*

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Gender Identity*

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Self-identify*

Are you of Hispanic/Latino origin?*

Select or enter value

Race*

Which of the following best describes your race? Select all that apply. Please note your race is different from whether or not you identify as Hispanic/Latino. For example, if you are of Hispanic/Latino origin, you may be a mix of American Indian/Alaska Native as well as Caucasian races. If you are not of Hispanic/Latino origin, you may still be a mix of American Indian/Alaska Native as well as Caucasian races. You may select "Unknown" if your race is unknown to you.

Select or enter value

First generation Bachelor's degree?*

Are you the first generation in your family to earn a bachelor's degree?

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Which of these apply(ied) to you as an undergraduate student?*

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Veteran*

Are you a veteran of the US Armed Forces?

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Disability*

Do you have any disabilities, defined as a physical or mental impairment that substantially limits one or more major life activities?

Select or enter value

Policy Acceptance

I agree to use any funds provided by UCSB through this program only for supporting and enabling the approved internship.*

I will not use any funds provided by UCSB through this program for any on-campus research or other activities.*

I certify that this internship complies with UCSB policies on intellectual property.*

Upon request, I agree to share my internship experience by providing a written summary, participating in an on-campus panel, or providing other inputs as required by CNSI to facilitate reporting to the State of California.*

Send me a copy of my responses

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