CRSP Application Part II

Transcription

CUNY Research Scholars Program (CRSP) Application – Part IIAcademic Year 2022-2023About the Program: The CUNY Research Scholars Program is a year-long program which providesfull-time students enrolled in associate degree programs with funded opportunities for laboratoryresearch with a faculty mentor. In addition to participation in research, the program includes mandatoryworkshops on lab safety, responsible conduct in research, and other research-related skills. Students mustalso complete training through Collaborative Institutional Training Initiative (CITI), if not done already,and submit their CITI certification within the first six weeks of the program; submit an abstract, preparea poster and participate in the poster sessions towards the end of the fall and spring semester; andparticipate in the CUNY-wide summer symposium at the conclusion of the program.Participating students commit to one full academic year plus the summer program, 400 hours ofresearch/independent study. The following is the program requirements for the number of hours:Fall semester:Winter/spring semester:Summer:60 hours or 6 hours/week60 hours or 6 hours/week280 hours 1000 1000 3000Eligibility: Full-time associate degree students at any stage in their academic career canparticipate. It is understood that some students will transfer to baccalaureate programs - this mayresult in students no longer being eligible to participate in the program. Baccalaureate students withless than 50 credits completed prior to their application are also eligible for this program.In order to maintain eligibility students must be full-time, and engage in laboratory experiences inthe Science, Technology, Engineering or Math (STEM) disciplines. This includes computerlaboratory experiences.The ApplicationPart I can be found at: https://www.surveymonkey.com/r/CRSPCityTechPart II of the applications includes:(1) PREA - Must be completed electronically and signed by both the student and faculty mentor.(2) CUNYFirst Expense Reimbursement form - Please clearly write your name, CUNYFirstID, address, telephone number, City Tech email address and sign the form.(3) W-9 – Please complete parts I and II and sign in part III- DO NOT INCLUDE YOURSOCIAL SECURITY NUMBER ON THE W9 FORM.(4) An unofficial copy of the student’s transcript, including Fall 2022 registration.

CRSP Requirements1. The CRSP application deadline (Parts I and II) is Thursday, September 22th, 2022.Part I should include the mentor information, project title, and project abstract bythis date. Please complete part I online and submit a completed part II to: Email:undergraduateresearch@citytech.cuny.edu –SUBJECT Line: CRSP application2. CRSP researchers are expected to attend the mandatory orientation meeting on Monday,October 3rd, 2022, from 1:00-2:00 PM, via Zoom.3. All students must also complete the responsible conduct in research online training andsubmit their Collaborative Institutional Training Initiative (CITI) certificate by Thursday,October 20th, 2022. Even if you have submitted this in previous semesters, you are stillrequired to submit a copy of the certification.More information on CITI training can be found at:https://www.citiprogram.org/Make sure not to click that you want college credit – if you indicate that you wantcollege credit the program then indicates that you have to pay for the certification.Submit the completion certification (pdf file) using the following Dropbox aXwGRjU4. Undergraduate researchers must attend at least four professional development workshops inthe fall and spring.*** For Updated detail information about the workshops ops.aspx5. In collaboration with the faculty mentor, prepare a final abstract summarizing theaccomplishments of the project. Mentors should proofread, edit, and upload it by ThursdayNovember 10th, 2022 at the following Dropbox sFlONN8Additionally, you should prepare your poster based on your final results for a postersession event. The poster file must be uploaded to a Dropbox link by WednesdayNovember 23rd, wrpQabESigning the consent form indicates permission to publish abstracts and posters on the collegewebsite.6. Participate in the Fall 2022 Honors and Research Scholars poster session and award ceremonyWednesday, November 30Virtual Poster Presentation (Poster Judging)Thursday, December 1Virtual Poster Presentation: Award Ceremony

7. Be a full-time student in good academic standing. Students also must attend another 4workshops and submit updated abstracts and posters in spring 2023. All dates for spring2023 and summer activities will be announced later.To optimize the number of mentors available to students and to ensure a proper depth offocus on scholarly work, CRSP students are limited to ONE research project per semester.Undergraduate research stipends are not available to those receiving stipends from anotherproject although they may participate in the program. Faculty mentors involving multiplestudents on a project should distinguish the expected roles to be performed by each studenton the Pre-Research Application (PREA).*Due to restrictions in funding, students must be US citizens or permanent residents (theymust have a social security number) to receive the stipend. They must be recommended by afaculty member into the program, and be in good academic standing, i.e. not placed onacademic probation. In order to be paid, a W-9 and Reimbursement Request forms must becompleted and submitted with the rest of the application. Stipends are sent to the homeaddress after the end of the semester (allow 6-8 weeks for processing). To ensure timelydelivery, please verify that the college has your correct address on file. At the AwardsCeremony, you will receive a certificate for your accomplishments.Program websites:Undergraduate Research: http://www.citytech.cuny.edu/research

Undergraduate ResearchPre-Research Application (PREA)-please type and attach an unofficial transcript1. Student Name/EMPL ID/address/email/phone2. Faculty MentorName/Department3. Title ofProject4. Description of Project5. What will the student’s role be in this project? What research skills will the student employ?6. What skills/values/knowledge learned in the classroom will the student employ?7. What research skills or other knowledge will the student learn?8. What “soft skills” will the faculty mentor address in this experience?a. Professional skillsGoal settingTime managementProfessional communication/behaviorb. Career planning and support

guidance in academic/career planningnetworking/making connections with professionals in the discipline9. What will the student contribute in terms of time commitment, quality of work, record keeping,preparatory work for meetings with mentor?10. What will the faculty mentor contribute in terms of time commitment, frequency of meeting withstudent, monitoring of and feedback on student work?CONSENTI hereby consent to the unrestricted use by New York City College of Technology (the College), TheCity University of New York (the University) and their related entities for the benefit of the College orthe University of (1) my name; (2) my photograph, portrait, picture or other likeness; (3) the name(s)of undergraduate college(s) attended, degree(s) earned and year(s) of graduation; (4) (a) the name(s) ofgraduate, professional or other school(s) attended or being attended and program(s) in which enrolledor (b) my job title(s) or position(s) held and name(s) of company(ies) or other concern(s) by whichformerly or now employed; and (5) any physical or audio/visual representation(s) thereof of exampleor examples of my classroom or laboratory course work for news, advertising or other promotionalpurposes or for the purposes of trade. I waive the right to inspect or approve any such materials relatedto such purposes and understand that I will receive no compensation for this consent.Signature of Student/DateSignature of Faculty Mentor/Date

CUNYfirstEXPENSE REIMBURSEMENT FOR NON-COLLEGE EMPLOYEESAND STUDENT STIPENDSDO NOT USE FOR HONORARIUMSCUNYFIRST ID#NAME (Print)FULL ADDRESSTELEPHONE# EMAILDESCRIPTION OF PAYMENTDEPARTMENT NAMEPAID ON STATE PAYROLL Y/NNYCCT STUDENT Y/NITEMIZED EXPENSE AMOUNTS AND BRIEF DESCRIPTIONS (PLEASE ATTACH RECEIPTS) GRAND TOTAL STUDENT STIPEND INFORMATIONSTUDENT STIPEND Y/NSEMESTER / YEARSTIPEND AMOUNT DEPARTMENT NAMECUNYFIRST NS AND APPROVALSRECEIPENT'S SIGNATUREDATEDEPARTMENTAL FUNDING SIGNATUREDATEA/P EXPENSE RECORD NO.

W-9Form(Rev. August 2013)Department of the TreasuryInternal Revenue ServiceRequest for TaxpayerIdentification Number and CertificationGive Form to therequester. Do notsend to the IRS.Print or typeSee Specific Instructions on page 2.Name (as shown on your income tax return)Business name/disregarded entity name, if different from aboveExemptions (see instructions):Check appropriate box for federal tax classification:Individual/sole proprietorC CorporationS CorporationPartnershipTrust/estateExempt payee code (if any)Limited liability company. Enter the tax classification (C C corporation, S S corporation, P partnership)Other (see instructions)Address (number, street, and apt. or suite no.)Exemption from FATCA reportingcode (if any)Requester’s name and address (optional)City, state, and ZIP codeList account number(s) here (optional)Part ITaxpayer Identification Number (TIN)Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” lineto avoid backup withholding. For individuals, this is your social security number (SSN). However, for aresident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For otherentities, it is your employer identification number (EIN). If you do not have a number, see How to get aTIN on page 3.XXX–XX–XXXXEmployer identification numberNote. If the account is in more than one name, see the chart on page 4 for guidelines on whosenumber to enter.Part IISocial security numberXX–XXXXXXXCertificationUnder penalties of perjury, I certify that:1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal RevenueService (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I amno longer subject to backup withholding, and3. I am a U.S. citizen or other U.S. person (defined below), and4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholdingbecause you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgageinterest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), andgenerally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See theinstructions on page 3.SignHereSignature ofU.S. personDateGeneral Instructionswithholding tax on foreign partners’ share of effectively connected income, andSection references are to the Internal Revenue Code unless otherwise noted.Future developments. The IRS has created a page on IRS.gov for informationabout Form W-9, at www.irs.gov/w9. Information about any future developmentsaffecting Form W-9 (such as legislation enacted after we release it) will be postedon that page.Purpose of FormA person who is required to file an information return with the IRS must obtain yourcorrect taxpayer identification number (TIN) to report, for example, income paid toyou, payments made to you in settlement of payment card and third party networktransactions, real estate transactions, mortgage interest you paid, acquisition orabandonment of secured property, cancellation of debt, or contributions you madeto an IRA.Use Form W-9 only if you are a U.S. person (including a resident alien), toprovide your correct TIN to the person requesting it (the requester) and, whenapplicable, to:1. Certify that the TIN you are giving is correct (or you are waiting for a numberto be issued),2. Certify that you are not subject to backup withholding, or3. Claim exemption from backup withholding if you are a U.S. exempt payee. Ifapplicable, you are also certifying that as a U.S. person, your allocable share ofany partnership income from a U.S. trade or business is not subject to the4. Certify that FATCA code(s) entered on this form (if any) indicating that you areexempt from the FATCA reporting, is correct.Note. If you are a U.S. person and a requester gives you a form other than FormW-9 to request your TIN, you must use the requester’s form if it is substantiallysimilar to this Form W-9.Definition of a U.S. person. For federal tax purposes, you are considered a U.S.person if you are: An individual who is a U.S. citizen or U.S. resident alien, A partnership, corporation, company, or association created or organized in theUnited States or under the laws of the United States, An estate (other than a foreign estate), or A domestic trust (as defined in Regulations section 301.7701-7).Special rules for partnerships. Partnerships that conduct a trade or business inthe United States are generally required to pay a withholding tax under section1446 on any foreign partners’ share of effectively connected taxable income fromsuch business. Further, in certain cases where a Form W-9 has not been received,the rules under section 1446 require a partnership to presume that a partner is aforeign person, and pay the section 1446 withholding tax. Therefore, if you are aU.S. person that is a partner in a partnership conducting a trade or business in theUnited States, provide Form W-9 to the partnership to establish your U.S. statusand avoid section 1446 withholding on your share of partnership income.Cat. No. 10231XForm W-9 (Rev. 8-2013)

Page 2Form W-9 (Rev. 8-2013)In the cases below, the following person must give Form W-9 to the partnershipfor purposes of establishing its U.S. status and avoiding withholding on itsallocable share of net income from the partnership conducting a trade or businessin the United States:Updating Your Information In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,the U.S. grantor or other U.S. owner of the grantor trust and not the trust, andYou must provide updated information to any person to whom you claimed to bean exempt payee if you are no longer an exempt payee and anticipate receivingreportable payments in the future from this person. For example, you may need toprovide updated information if you are a C corporation that elects to be an Scorporation, or if you no longer are tax exempt. In addition, you must furnish a newForm W-9 if the name or TIN changes for the account, for example, if the grantorof a grantor trust dies. In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than agrantor trust) and not the beneficiaries of the trust.PenaltiesForeign person. If you are a foreign person or the U.S. branch of a foreign bankthat has elected to be treated as a U.S. person, do not use Form W-9. Instead, usethe appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Taxon Nonresident Aliens and Foreign Entities).Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you aresubject to a penalty of 50 for each such failure unless your failure is due toreasonable cause and not to willful neglect. In the case of a disregarded entity with a U.S. owner, the U.S. owner of thedisregarded entity and not the entity,Nonresident alien who becomes a resident alien. Generally, only a nonresidentalien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax oncertain types of income. However, most tax treaties contain a provision known asa “saving clause.” Exceptions specified in the saving clause may permit anexemption from tax to continue for certain types of income even after the payeehas otherwise become a U.S. resident alien for tax purposes.If you are a U.S. resident alien who is relying on an exception contained in thesaving clause of a tax treaty to claim an exemption from U.S. tax on certain typesof income, you must attach a statement to Form W-9 that specifies the followingfive items:1. The treaty country. Generally, this must be the same treaty under which youclaimed exemption from tax as a nonresident alien.2. The treaty article addressing the income.3. The article number (or location) in the tax treaty that contains the savingclause and its exceptions.4. The type and amount of income that qualifies for the exemption from tax.5. Sufficient facts to justify the exemption from tax under the terms of the treatyarticle.Example. Article 20 of the U.S.-China income tax treaty allows an exemptionfrom tax for scholarship income received by a Chinese student temporarily presentin the United States. Under U.S. law, this student will become a resident alien fortax purposes if his or her stay in the United States exceeds 5 calendar years.However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30,1984) allows the provisions of Article 20 to continue to apply even after theChinese student becomes a resident alien of the United States. A Chinese studentwho qualifies for this exception (under paragraph 2 of the first protocol) and isrelying on this exception to claim an exemption from tax on his or her scholarshipor fellowship income would attach to Form W-9 a statement that includes theinformation described above to support that exemption.If you are a nonresident alien or a foreign entity, give the requester theappropriate completed Form W-8 or Form 8233.What is backup withholding? Persons making certain payments to you mustunder certain conditions withhold and pay to the IRS a percentage of suchpayments. This is called “backup withholding.” Payments that may be subject tobackup withholding include interest, tax-exempt interest, dividends, broker andbarter exchange transactions, rents, royalties, nonemployee pay, payments madein settlement of payment card and third party network transactions, and certainpayments from fishing boat operators. Real estate transactions are not subject tobackup withholding.You will not be subject to backup withholding on payments you receive if yougive the requester your correct TIN, make the proper certifications, and report allyour taxable interest and dividends on your tax return.Payments you receive will be subject to backupwithholding if:1. You do not furnish your TIN to the requester,2. You do not certify your TIN when required (see the Part II instructions on page3 for details),3. The IRS tells the requester that you furnished an incorrect TIN,4. The IRS tells you that you are subject to backup withholding because you didnot report all your interest and dividends on your tax return (for reportable interestand dividends only), or5. You do not certify to the requester that you are not subject to backupwithholding under 4 above (for reportable interest and dividend accounts openedafter 1983 only).Certain payees and payments are exempt from backup withholding. See Exemptpayee code on page 3 and the separate Instructions for the Requester of FormW-9 for more information.Also see Special rules for partnerships on page 1.What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA)requires a participating foreign financial institution to report all United Statesaccount holders that are specified United States persons. Certain payees areexempt from FATCA reporting. See Exemption from FATCA reporting code onpage 3 and the Instructions for the Requester of Form W-9 for more information.Civil penalty for false information with respect to withholding. If you make afalse statement with no reasonable basis that results in no backup withholding,you are subject to a 500 penalty.Criminal penalty for falsifying information. Willfully falsifying certifications oraffirmations may subject you to criminal penalties including fines and/orimprisonment.Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,the requester may be subject to civil and criminal penalties.Specific InstructionsNameIf you are an individual, you must generally enter the name shown on your incometax return. However, if you have changed your last name, for instance, due tomarriage without informing the Social Security Administration of the name change,enter your first name, the last name shown on your social security card, and yournew last name.If the account is in joint names, list first, and then circle, the name of the personor entity whose number you entered in Part I of the form.Sole proprietor. Enter your individual name as shown on your income tax returnon the “Name” line. You may enter your business, trade, or “doing business as(DBA)” name on the “Business name/disregarded entity name” line.Partnership, C Corporation, or S Corporation. Enter the entity's name on the“Name” line and any business, trade, or “doing business as (DBA) name” on the“Business name/disregarded entity name” line.Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded asan entity separate from its owner is treated as a “disregarded entity.” SeeRegulation section 301.7701-2(c)(2)(iii). Enter the owner's name on the “Name”line. The name of the entity entered on the “Name” line should never be adisregarded entity. The name on the “Name” line must be the name shown on theincome tax return on which the income should be reported. For example, if aforeign LLC that is treated as a disregarded entity for U.S. federal tax purposeshas a single owner that is a U.S. person, the U.S. owner's name is required to beprovided on the “Name” line. If the direct owner of the entity is also a disregardedentity, enter the first owner that is not disregarded for federal tax purposes. Enterthe disregarded entity's name on the “Business name/disregarded entity name”line. If the owner of the disregarded entity is a foreign person, the owner mustcomplete an appropriate Form W-8 instead of a Form W-9. This is the case even ifthe foreign person has a U.S. TIN.Note. Check the appropriate box for the U.S. federal tax classification of theperson whose name is entered on the “Name” line (Individual/sole proprietor,Partnership, C Corporation, S Corporation, Trust/estate).Limited Liability Company (LLC). If the person identified on the “Name” line is anLLC, check the “Limited liability company” box only and enter the appropriatecode for the U.S. federal tax classification in the space provided. If you are an LLCthat is treated as a partnership for U.S. federal tax purposes, enter “P” forpartnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to betaxed as a corporation, enter “C” for C corporation or “S” for S corporation, asappropriate. If you are an LLC that is disregarded as an entity separate from itsowner under Regulation section 301.7701-3 (except for employment and excisetax), do not check the LLC box unless the owner of the LLC (required to beidentified on the “Name” line) is another LLC that is not disregarded for U.S.federal tax purposes. If the LLC is disregarded as an entity separate from itsowner, enter the appropriate tax classification of the owner identified on the“Name” line.Other entities. Enter your business name as shown on required U.S. federal taxdocuments on the “Name” line. This name should match the name shown on thecharter or other legal document creating the entity. You may enter any business,trade, or DBA name on the “Business name/disregarded entity name” line.ExemptionsIf you are exempt from backup withholding and/or FATCA reporting, enter in theExemptions box, any code(s) that may apply to you. See Exempt payee code andExemption from FATCA reporting code on page 3.

Page 3Form W-9 (Rev. 8-2013)Exempt payee code. Generally, individuals (including sole proprietors) are notexempt from backup withholding. Corporations are exempt from backupwithholding for certain payments, such as interest and dividends. Corporations arenot exempt from backup withholding for payments made in settlement of paymentcard or third party network transactions.Note. If you are exempt from backup withholding, you should still complete thisform to avoid possible erroneous backup withholding.The following codes identify payees that are exempt from backup withholding:1—An organization exempt from tax under section 501(a), any IRA, or acustodial account under section 403(b)(7) if the account satisfies the requirementsof section 401(f)(2)2—The United States or any of its agencies or instrumentalities3—A state, the District of Columbia, a possession of the United States, or any oftheir political subdivisions or instrumentalities4—A foreign government or any of its political subdivisions, agencies, orinstrumentalities5—A corporation6—A dealer in securities or commodities required to register in the UnitedStates, the District of Columbia, or a possession of the United States7—A futures commission merchant registered with the Commodity FuturesTrading Commission8—A real estate investment trust9—An entity registered at all times during the tax year under the InvestmentCompany Act of 194010—A common trust fund operated by a bank under section 584(a)11—A financial institution12—A middleman known in the investment community as a nominee orcustodian13—A trust exempt from tax under section 664 or described in section 4947The following chart shows types of payments that may be exempt from backupwithholding. The chart applies to the exempt payees listed above, 1 through 13.IF the payment is for . . .THEN the payment is exempt for . . .Interest and dividend paymentsAll exempt payees exceptfor 7Broker transactionsExempt payees 1 through 4 and 6through 11 and all C corporations. Scorporations must not enter an exemptpayee code because they are exemptonly for sales of noncovered securitiesacquired prior to 2012.G—A real estate investment trustH—A regulated investment company as defined in section 851 or an entityregistered at all times during the tax year under the Investment Company Act of1940I—A common trust fund as defined in section 584(a)J—A bank as defined in section 581K—A brokerL—A trust exempt from tax under section 664 or described in section 4947(a)(1)M—A tax exempt trust under a section 403(b) plan or section 457(g) planPart I. Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. If you are a resident alien and you do nothave and are not eligible to get an SSN, your TIN is your IRS individual taxpayeridentification number (ITIN). Enter it in the social security number box. If you do nothave an ITIN, see How to get a TIN below.If you are a sole proprietor and you have an EIN, you may enter either your SSNor EIN. However, the IRS prefers that you use your SSN.If you are a single-member LLC that is disregarded as an entity separate from itsowner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (orEIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC isclassified as a corporation or partnership, enter the entity’s EIN.Note. See the chart on page 4 for further clarification of name and TINcombinations.How to get a TIN. If you do not have a TIN, apply for one immediately. To applyfor an SSN, get Form SS-5, Application for a Social Security Card, from your localSocial Security Administration office or get this form online at www.ssa.gov. Youmay also get this form by calling 1-800-772-1213. Use Form W-7, Application forIRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4,Application for Employer Identification Number, to apply for an EIN. You can applyfor an EIN online by accessing the IRS website at www.irs.gov/businesses andclicking on Employer Identification Number (EIN) under Starting a Business. Youcan get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800TAX-FORM (1-800-829-3676).If you are asked to complete Form W-9 but do not have a TIN, apply for a TINand write “Applied For” in the space for the TIN, sign and date the form, and give itto the requester. For interest and dividend payments, and certain payments madewith respect to readily tradable instruments, generally you will have 60 days to geta TIN and give it to the requester before you are subject to backup withholding onpayments. The 60-day rule does not apply to other types of payments. You will besubject to backup withholding on all such payments until you provide your TIN tothe requester.Note. Entering “Applied For” means that you have already applied for a TIN or thatyou intend to apply for one soon.Caution: A disregarded U.S. entity that has a foreign owner must use theappropriate Form W-8.Barter exchange transactions andpatronage dividendsExempt payees 1 through 4Payments over 600 required to be1reported and direct sales over 5,000Generally, exempt payees21 through 5To establish to the withholding agent that you are a U.S. person, or resident alien,sign Form W-9. You may be requested to sign by the withholding agent even ifitems 1, 4, or 5 below indicate otherwise.Payments made in settlement ofpayment card or third party networktransaction

(2) CUNYFirst Expense Reimbursement form - Please clearly write your name, CUNYFirst ID, address, telephone number, City Tech email address and sign the form. (3) W-9 - Please complete parts I and II and sign in part III-DO NOT INCLUDE YOUR SOCIAL SECURITY NUMBER ON THE W9 FORM.