Research Foundation Cover Sheet Office of the Vice Provost for Research 118 College Hall / 6303 215-898-7236 Spring Cycle 2005 A completed cover sheet must accompany each copy of the application. Principal Investigators: Rank: Phone Number: E-mail Address: Department: School: Campus Address: Mail Code: Business Administrator: * Name: * Phone: * Email: Title of Proposal: Amount Requested: Does the project involve the use of any of the following: Human Subjects? Animals? Radioactive Material/Radiation Producing Equipment? Investigational new drugs or new devices? Potentially infectious agents, including human blood or tissue? Carcinogens? In vitro formation of recombinant DNA? Please indicate below which Committee you would prefer to review your proposal: Biomedical Humanities Social Science & Management Natural Science & Engineering Please indicate below the priority classification for your proposal: Helping junior faculty undertake pilot projects Helping established faculty perform exploratory research Providing support in disciplines where extramural support is difficult to obtain Providing modest institutional matching funds (contingent upon a successful external peer- reviewed application that requires an institutional match) FYI--ALL INVESTIGATORS MUST HAVE A 26 DIGIT BUDGET CODE TO ACCESS AWARD FUNDS SIGNATURES: Dean:______________________________________________ Department Chair: ___________________________________ Principal Investigator: _______________________________