Chris4Life Research Program Application Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Page 1 General Information Project Title Applicant First Name Applicant Last Name Highest Degree(s) Position Title Academic Rank Applicant’s Current Institution Institution Mailing Address Division Department Applicant Email Address Applicant Phone Number Applicant Fax Number I am a United States citizenYesNo My project is compliant with the Tobacco Policy YesNoProposals that are not compliant with the Tobacco Policy will not be considered. My research will be conducted within the 50 United StatesYes Page 2 Project Information Dates of Proposed Project From: To: Proposed Budget Amount Use of Human Subjects?YesNo IRB Protocol number IRB StatusPlease select... Not submitted Under review Approved Approved and modification pending IRB Date MM/DD/YYYY Recombinant DNA number Recombinant DNA StatusPlease select... Not submitted Under review Approved Approved and modification pending Recombinant DNA Date MM/DD/YYYY Biohazards?YesNo Page 3 Is there an administrator who will sign off on your project?YesNo Administrator Information First Name Last Name Title Institution Institution Mailing Address Phone Number Fax Number Email address Co-investigator(s)?YesNo Co-investigator Information First Name Last Name Role Title Institution Institution Mailing Address Division Department Email address Phone Number Fax Number Page 4 Layperson's Summary limit 2000 characters Technical Abstract limit 2000 characters Statement of Significance limit one page Specific Aims limit one page Background limit two pages Methods limit five pages Timetable limit one page Evaluation limit two pages Biographical Sketch (Principal Investigator) limit five pages Biographical Sketch (Co-investigator) limit five pages Grant Budgets limit one page/year Budget Justification limit one page/year List of Literature cited Letters of Support Letters of Collaboration Page 5 Administrator Signature Signature Date Save my progress and resume later | Resume a previously saved form Need assistance with this form?
