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Research Proposal Transmittal Form

***NOTE: Print and complete. A copy of the program announcement must be attached to this form. ***

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Proposal Title:

Principal Investigator:

Daytime Phone:

Nighttime Phone:

Co-Investigator(s)

 

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Funding Agency:

Total Cost: $

Direct Cost: $

Indirect Cost: $

Anticipated Award Period: MM/DD/YY to MM/DD/YY

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Grant Submission Deadline:

Is sufficient space already allocated? (circle)

NO

YES

If yes, specify rooms:

 

 

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Signatures and Dates:

Principal Investigator:

Date:

 

PI's Department Chair:

Date:

 

Director of Equipment User Facility:

Date:

 

Associate Dean for Research:

Date:

 

Director of Business Administration:

Date:

 

Dean, School of Dentistry:

Date:

 

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Please complete the following and return to the Office of the Dean as the status of grant changes.

Status (circle):

Rejected

Awarded

Withdrawn

Date:

Awarded Total Cost: $

Direct Cost: $

Indirect Cost: $

Funded Period:

ELIGIBLE FOR AMENDED APPLICATION/COMPETING CONTINUATION? (Circle):

NO

YES

If yes, enter date: