2015-2016 

Instructions: Complete and email to:  CLewisGrant@hotmail.com

 

 

Name:

Address:

City:                                         State:      Zip:

 

Telephone:

FAX:

E-Mail:

 

 

Project Title:                                                                       Professor/Mentor:

 

 

Problem to be Addressed and Why Important:

 

 

 

 

Objectives:

 

 

 

 

 

 

 

 

Project Location:

 

Beginning and Ending Dates (including prior work):                                  

Estimated Project Time (Hours):

 

Estimated Total Cost: $                  (Attach budget). 

Anticipated Additional Funding Sources and Amounts:

 

                                  

Identify in the budget how the Chadwick Lewis Memorial Grant will be used (money cannot be used for indirect costs associated with the project):

 

 

 

How will this grant help with research or conservation of reptiles and amphibians in Tennessee?

 

 

 

 

 

 

The recipient of the Chadwick Lewis Memorial Grant is required to present their results or a progress report at the next statewide meeting of the Tennessee Herpetological Society.

 

Signature:  ___________________________________Date:______________________________