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Office of the Provost and Executive Vice President

Application for Big 12 Faculty Fellowship

(Please Indicate Category of Application)

Regular Fellowships
Mentoring component
Name of K-State faculty mentor:
Name of Applicant:
Academic Rank:
Campus Phone:
E-Mail Addresss:
Name of Host University:
Name of Host Department/Unit:
Name of Faculty Host:
Dates of Proposed Visit:
Title of Project:

Abstract or Brief Description of Proposed Visit (limited space provided on application form)

Attach a more complete description of the proposed visit (not to exceed two pages). Please address the following issues.
  • Describe the purpose and activities of your visit.
  • Describe how your proposed visit will complement your current or proposed new area of teaching/research/service.
  • Describe how you, K-State and the host university/unit/faculty will benefit from this experience.

Attach a copy of the letter of invitation from the host institution. This letter should indicate their willingness to accept you as a visitor and also that they can accommodate your specific technical needs such as lab space or access to materials in the library as well as access to key individuals.

Describe how your duties at Kansas State University will be covered in your absence.

Budget (provide detail):

Other (Specify & Itemize):

Total Budget:

Signature of Applicant

Signature of Department Head

Signature of Dean





Submit electronically in pdf format, both the completed application and a one page Vita to provounivawards@ksu.edu