Worksheet: Individual Application

Below is a list of the fields for the Individual Impact Award Application for reference and to aid in preparation:

When ready, you may apply using the Individual Application.

INDIVIDUAL APPLICATION WORKSHEET

Last Name:

First Name:

Catawba ID:

Are you a student In the Honors Program?

  • Please Select - Yes                 No

Are you a full scholarship student-athlete?

  • Please Select - Yes                 No

Prior Impact Award amount to date Advisor Name:

Advisor Email:

Area of study

What Is your current GPA?

What Is your current class status?

  • Please Select - Freshman                Sophomore                Junior                Senior

Funded Semester/Term

  • Please Select - Fall 2025    Winter 2025 Spring  2026     Summer 2026     Fall 2026


Primary Mentor for the Application

First & Last Name:

Email:

 

Award Request Purpose

Project:

  • Choose - Service                 Research                  Creative

Is Travel Required?

  • Please Select - Yes                 No

Internship Type:

Credit                 Non Credit

Internship Area/Affiliation:

 

Dates for your experience?

From:

To:

Estimated date that the 1st payment(s) for your experience are due?

Impact Award Pre-Eligibility Amount *Note: This is an estimate and will be reviewed prior to awarding.

Amount Requested:

Budget Description:

Please attach a brief project/ trip proposal (250 words or less):

 

Is IRB Approval Required?

- Please Select -                     Yes                  No

If yes, please provide an explanation:  

I agree to fill out the post-experience reflection request about my IA project/travel/internship. Reflection requests will be sent at the end of the semester of your supported project/travel/internship.

Signature

Date