Hazel Barnes Flat Application Form

Name *

Email *

Enter your @colorado.edu email address. Your application will not be considered if you enter a non-CU email address.

Department/Center/Institution *

CU Boulder Affiliation *

Graduate Student

Assistant Professor

Associate Professor

Full Professor

Non-tenure professor

Staff or Administration

Retired Emeritus Faculty within 3 years (active research)

Student ID *

Graduate Program Coordinator Name *

Name and email for Department Finance Person, Business, or Program Manager: *

Have you used the Hazel Barnes Flat in the past? *

Yes

No

If yes, how many times have you used the flat?

Would you like to be considered for a Schwalbe Travel Award? See website for amounts by rank. *

Yes

No

Do you have alternative funding that could be used to support this travel opportunity? *

Yes

No

Accompanying Guests *

Occupancy of the flat is currently limited to three persons comprised of one household or one research team applying together. The flat has one double and one single bed.

I will be the single occupant of the flat

I will be traveling with additional members of my household or research team

Guest Information *

Enter the guest's NAME, EMAIL and RELATIONSHIP TO APPLICANT (guests under 18 do not need to enter email address)

Expectations *

My CU Boulder appointment will be active during the dates in which the HBF is being requested

I commit to completing the Occupancy Agreement at least 3 weeks prior to the HBF visit

I commit to providing a written summary of activities and research completed within 30 days

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Hazel Barnes Flat Application Form