Project Title
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Principal Investigator Name
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Principal Investigator Department
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Principal Investigator Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Principal Investigator E-mail
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Number of Project Key Personnel
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Key Personnel 1 Name
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Key Personnel 1 Department
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Key Personnel 1 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 2 Name
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Key Personnel 2 Department
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Key Personnel 2 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 3 Name
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Key Personnel 3 Department
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Key Personnel 3 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 4 Name
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Key Personnel 4 Department
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Key Personnel 4 Rank
* must provide value
Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 5 Name
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Key Personnel 5 Department
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Key Personnel 5 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 6 Name
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Key Personnel 6 Department
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Key Personnel 6 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 7 Name
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Key Personnel 7 Department
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Key Personnel 7 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 8 Name
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Key Personnel 8 Department
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Key Personnel 8 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Key Personnel 9 Name
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Key Personnel 9 Department
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Key Personnel 9 Rank
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Professor Associate Professor Assistant Professor Instructor Other
If 'Other', please specify.
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Abstract (300 words max)
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Research Plan (6 pages max)
Specific Aims
Significance - Explain how the project addresses an important problem, how it will improve scientific knowledge, technical capability and/or clinical practice.
Innovation - Explain if this project uses novel concepts, approaches or methodologies, instrumentation, or interventions.
Approach - Describe the overall strategy for this project. This should include a feasible project plan that can be completed within a year. Consideration of expected outcomes, potential pitfalls and alternative strategies should be included.
Projected Timeline including next steps (e.g., submission of extramural applications)
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References (no page limit)
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Does the proposed work involve human subjects?
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Yes No Unsure
Protection of Human Subjects
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IRB Approval
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Already have IRB approval for the proposed work Plan on submitting an amendment to an existing IRB approved project if funded Plan on initiating a new IRB application if funded IRB approval is not needed for the proposed work
IRB Number
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Please explain why IRB approval is not needed for a project involving human subjects.
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Does the proposed work involve live vertebrates?
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Yes No Unsure
IACUC Approval
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Already have IACUC approval for the proposed work Plan on submitting an amendment to an existing IACUC approved project if funded Plan on initiating a new IACUC application if funded IACUC approval is not needed for the proposed work
Please explain why IACUC approval is not needed for project involving live vertebrates.
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IACUC Number
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Finalized Budget Upload (using Center Budget Template)
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Budget Justification
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Biosketch for ______
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Letter(s) of Support, if needed
Other Supporting Documentation, if needed
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