INTENT TO SEEK EXTERNAL FUNDING FOR WAGNER COLLEGE Members of the campus community who are seeking external funding from corporations, foundations, or government agencies MUST submit this Intent to Seek External Funding form prior to proposal development. Submitting this form will ensure that campus personnel involved with external support activities receive early notice of upcoming grant activity and will enable the Institutional Advancement and Provost Offices to coordinate campus outreach efforts to funders. This will also allow us to alert those on campus who can assist you with the proposal and budget development. Please submit this form as early as possible but minimally one month before the proposal due date along with the request for proposals or grant application guidelines (if appropriate). If you have any questions, please contact Patrick Mooney at patrick.mooney@wagner.edu or for faculty, Dr. Taviare Hawkins at taviare.hawkins@wagner.edu. Name* First Last Title* Department/Office*Email* Phone*Project Title*Estimated proposal request amount*Estimated Proposal Due Date* Date Format: MM slash DD slash YYYY Who are you currently working with for this submission?* Patrick Mooney Tav Hawkins (Faculty) Status of Grant* New Grant Renewal Funding Classification Corporation/Foundation Federal State Private/Other Will this submission require matching funds?* Yes No If yes, please list the amount, whether approval has been given, and by whom.*Please identify any additional potential funding sources you are already considering (if any)Will your submission be with an external collaborator?* Yes No External Collaborators Name and/or InstitutionExternal Collaborator's Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country External Collaborator's PhoneCompliance Issues - If any please provide a brief summaryPlease attach a short project description (1 page). Include the purpose of the project, project outcomes, assessment, and a possible timeline. If funds will be split between collaborators, include this information in the description as well. This information provided here will be added to the Wagner College tracking document that is presented quarterly to senior staff and the board of trustees.*If appropriate, a copy of the Request for Proposals or Grant Application Guidelines.EmailThis field is for validation purposes and should be left unchanged.