Research Illustration Request Form | Office of the Vice Provost for Research

Today's Date

Name

School

Department

Phone Number

Email Address

Article Title

Project Deadline (date planned to submit the manuscript or publicly release information)

NOTE—project requests must be submitted 5 full weeks prior to this deadline in order to be eligible for consideration

Publication date (if known)

Where will the manuscript be submitted (or presented)?

Are there any other places you would like to use the potential artwork? (on your website, powerpoint presentations, proposal, etc)

Please explain the significance of the work and why it will be of interest to a non-technical audience:

Please describe what you think needs to be depicted in the artwork

Are you willing to discuss the work with GW writers and/or news media?