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2023 Global Field Experience Financial Award Acceptance Agreement

My project will be conducted:
My project will be conducted:
Please read this form carefully to make sure you fully understand the terms and conditions of accepting this award.  You are required to complete, sign and upload the following forms before your award can be processed. Please be aware that failure to complete any of the following items will result in delay or termination of your award.  Disbursement of funds to your direct deposit account will take anywhere from6-9 weeks for processing after the completed forms are sent to Accounts Payable.
Given the evolving nature of the COVID-19 outbreak, certain destinations may face travel restrictions and travel plans may need to be changed. If you make travel-related purchases now, make sure you carefully read the applicable cancellation policies. If travel and projects are disrupted for reasons out of your control, we will discuss each situation on a case-by-case basis.

Please review and continue to follow Emory’s Coronavirus Updates: https://www.emory.edu/forward/index.html; and the CDC’s COVID-19 Travel Information: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

As a reminder, appropriate use of award funds includes:
  • Travel to and from the field site
  • Visa and passport fees
  • Immunizations
  • Room and board while at the field site
  • Direct project costs (transportation and incentives for participants, translators, equipment, lab supplies, etc.)
The following documentation must be submitted BEFORE we can process your award:
Global Field Experience Award Letter Email-Shows donor and award amount (upload a copy of the full award letter that you were emailed.)
If your project involves Human Subjects Research, provide proof of IRB submission or justification for the project being deemed exempt by IRB or faculty guide.

Supplier Form
  • Please gather your banking information in advance.  In order to complete the form required for direct deposit, you will need:
    • The name of the receiving bank:
    • Routing number:
    • Accounting number:
  • Next please go to this site: https://www.finance.emory.edu/home/procurement/support-center/index.html   
  • Select this form by clicking on it: "New Supplier Information Form (SIF) for Domestic and Foreign Suppliers/Individuals/Study Participants"
    1. This will open a downloadable Excel file.  Save the file with your name in the file name.
    2. Complete the excel form fields (the form will expand as you fill in each cell); some fields have corresponding drop-down menus to select from.
    3. Once you have completed the full form, including both the Supplier section and the ACH section, save it and upload it below as a PDF document.
Please upload your New Supplier Information form (the completed excel file converted to 2- page PDF) below. If you experience any issue with the submission of this form, please contact Gerald Clay so that this document can be added to your agreement. 

**FOR INTERNATIONAL STUDENTS** PLEASE NOTE THAT YOU MUST COMPLETE AND UPLOAD A W8-BEN TAX FORM AS DIRECTED ON THE SIF FORM**  YOUR PAYMENT WILL NOT BE PROCESSED IF THE FORM IS NOT UPLOADED**** 

In addition to submitting all the required forms, you must assure you will complete the following:
  1. You are required to participate in and complete assignments in the Canvas Module "RSPH_Public_Health_Fieldwork 2023". Contact Gerald Clay to enroll if this course is not already on your dashboard in Canvas.
  2. Utilize the Emory Travel Department or Emory affiliated travel company to make your flight arrangements (YOU must ensure that your travel details are registered with ISOS)
  3. Provide detailed information to the GFE Program Coordinator on where you will stay during your project including on-site address and contact telephone numbers. You will communicate any changes to accommodation or contact information to the GFE Project Coordinator.
  4. Export Control forms may be necessary for any large electronic equipment you are taking with you.
  5. Pre-register for classes or be a Graduate in Residence at Emory University in the fall semester after the global field experience.
  6. Register online with International SOS and create a profile including your itinerary; provide screen-shots demonstrating this has been done (submit via Canvas Course).
  7. Follow the Emory Honor and Conduct Code as well as applicable standards of conduct of the host organization.
  8. Abide by the laws of the host-country (if applicable).
  9. Obtain health insurance that will cover you in the destination country (if applicable).
  10. Complete the deliverables described in your application for funding and provide them to the host site. (Adjustments to deliverables may occur in consultation with the site supervisor, provide documentation in writing.) Failure to complete and share deliverables may result in the student paying back the amount of the GFEFA. The host site will confirm receipt of deliverables.
  11. Emory Travel Release and Liability Waiver (this form is included in the Canvas Module, please submit it there).
  12. Should the security level of your site escalate or travel become inadvisable after this award notification, please contact Dr. McFarland. These situations will be assessed on a case by case basis.
Upon completion of this experience, you are required to :
  • Provide a one-page e-mail summary of your project and deliverables and at least one picture (high-resolution jpeg format) that captures your field experience and is suitable for posting on the Global Field Experience Financial Award website.
  • Participate in debriefing meetings/information sessions/ GFE award promotional opportunities, etc. to promote the award
  • Completion of the Summer Field Experience survey, emailed to  2nd-year students in the fall
  • Provide a thank you letter to the donor(s) who sponsored your award
Please sign below to confirm your acceptance of the terms and conditions of this award.
Date:
Date: