Application To Do Research On L-A-D Foundation
Property
We ask that you send us this completed application for our review and
written approval.
Once your project is approved we ask that you keep us
updated at least semi-annually while your research is
ongoing. We also require that you furnish us with any paper
or publication resulting from your work. Call, e-mail or
write us with any questions.
First Name _______________Last Name
_______________________ Middle Initial _____
Current Address:
Street________________________________________________________
City ____________________________ State _______________
Zip Code_______________
Daytime Phone _________________ Evening Phone
______________ Fax_______________
E-mail
address_______________________________________________________________
Permanent Address:Street_______________________________________________________
City ____________________________ State _________Zip Code
_________________
Daytime Phone ________________ Evening
Phone_______________Fax________________
1.) Date you would like to begin your research activity?
______________________________
2.) Date you anticipate completing your study?
___________________________________
3.) Are you undertaking this study as a student in a
college or university? _____
If so, toward what degree and area of concentration will
this work count?
_______________
_______________________________________________________________
What is the name of your school and
department?__________________________________
What is the name of your advisor?
______________________________________________
4.) Are you undertaking this study as a faculty member in
a college or university? _____ If so,
what is the name of your school and department?
________________________________
What is your position there?
____________________________________________________
5.) Summarize the nature of your research. Include the
project’s title, methods you will use and the
specific aspects of the land you seek to investigate.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
While my research is ongoing, I agree to contact the
L-A-D Foundation office at least annually with a progress
report. Upon the study’s completion, I agree to provide a
copy of any research paper, thesis, dissertation and/or
publication which results.
Signature _________________________________________ Date
______________________
MAIL THIS FORM TO: L-A-D Foundation, 721 Olive, Room
1016, St. Louis, Missouri 63101 Questions? Call (314)621-0230
You can e-mail us at: |