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ABOUT
CiPASS
Staff
OPPORTUNITIES
For Students
For Faculty
For Employers
PROGRAMS
CAUSE
Math Summer Bridge
Transfer Bridge
CiPASS STEM Summer Internship
CiPASS Apprenticeship Program
Project Based Learning
Transfer Mentorship Program
Engagement & Events
Early Alert System
FACILITIES
Gallery
CONTACT
Home
Project Request Form
Project Request Form
REQUESTOR INFORMATION
PI are required to select team members from the CIPASS applicant pool. Consideration will be given to students recommended by PI, but their selection is not guaranteed, and all team members recommended by the PI must apply to the program with the student application.
Industry collaboration is an important criteria for selection for faculty-led projects
Name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
Suffix
Phone
*
Email
*
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Please upload your CV
*
Accepted file types: pdf, doc, docx, Max. file size: 512 MB.
2 pages max.
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Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type of application
*
CCNY affiliated
Industry/Non-CCNY
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Company (if applicable):
Non-Academic Partner
Company/Organization:
*
Contact Information
*
Contact First Name
Contact Last Name
Suffix
Contact Title
Contact Title
Contact Email
*
Contact Email
Contact Phone
*
Contact Phone
AREA OF YOUR PROJECT
Area_Project1
Area_Project2
Area_project3
PROJECT DESCRIPTION
Project Title
Please Describe Your Project
*
Include overall goal for the project, specific activities that will be undertaken by students during the summer.
In what ways is a partner (industry, NGO, government, etc.) involved in this project, and how will that partner contribute (e.g. mentoring, training, supplies, manufacturing, funding, etc.).
OR
Are you interested in making connections with external partners for this project? What aspects of your project would lend themselves to partnerships and connections? Please share details so we can assist you in outreach to industry/external partners.
Additional Documents, if you consider
Drop files here or
Select files
Accepted file types: jpg, png, pdf, doc, docx, ppt, pptx, Max. file size: 64 MB, Max. files: 3.
1. What facilities do you anticipate utilizing for this project? Is any of the student work planned to be done remotely? If you are planning to use the CCNY MakerSpace, please indicate about how many hours/days per week, what type of equipment and materials you will use. We do not oversee the MakerSpace so we will need to let them know, as they run their own trainings and protocols.
*
Max 100 WORDS
Project Deliverables and Time Frame
Deliverable list & due dates for those milestones.
*
Deliverable(s)
Due Date
Project Team
Interns are undergraduate students and must be selected from the pool of applicants to the CiPASS Program. If you have potential students in mind, they must apply through the same mechanism.
Team size
*
two
Three
Other
Are there students you have in mind for this project? Please list names. (If so, they MUST apply to the CiPASS internship application to be eligible; we do not guarantee they will be selected but will keep them in high consideration)
Yes
No
Name students you have in mind.
Skills you would like students to come into the project with:
*
Skills you are willing/able to train students on:
*
If a graduate student will be the primary mentor (with faculty supervision), who will that be?
Project Budget and Expenses
PLEASE NOTE: A PRESENTATION AND REPORT WILL BE REQUIRED IN AUGUST FOR EACH PROJECT. DETAILED INSTRUCTIONS WILL BE PROVIDED TO PROJECTS SELECTED FOR CIPASS SUPPORT.
Will you be seeking financial support from CiPASS ?
*
Student stipends are $3,800 for the summer; mentors are eligible for up to $500 in materials budget per student and $1,000 per student on your team in mentor financial support (e.g. 2 student team = $500 materials and $2,000 mentor financial support). Note that this is paid via summer salary and if your summer salary is already fully accounted for, we will not be able to pay you. If a graduate student will be the primary mentor, we are able to accommodate this.
No
Yes
Budget and Expenses
*
EXPENSE ITEM
ESTIMATED COST
Total
*
Is any of your proposed budget for this project supplied by another funding source?
*
No
Yes
Please confirm that you will be available for meetings with students during normal east coast business hours at least weekly, and a responsible mentor will be available to the students in person/on campus for day-to-day supervision (graduate student is acceptable)
*
No
Yes
How much, and from which source ?
*
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