ITP Submission

All faculty must consult with their Department Chair, Associate Dean, and Dean prior to completing this ITP. Dean/Provost approval will be required before RSC can assist with your proposal submission.

P.I./USM Lead Name:

Email Address:

College/Program Area:

Collaborating P.I./P.D. Name:

Collaborating P.I./P.D. Email Address:

College/Program Area:

Collaborating P.I./P.D. #2 Name:

Collaborating P.I./P.D. #2 Email Address:

College/Program Area:

Collaborating P.I./P.D. #3 Name:

Collaborating P.I./P.D. #3 Email Address:

College/Program Area:

Collaborating P.I./P.D. #4 Name:

Collaborating P.I./P.D. #4 Email Address:

College/Program Area:

Collaborating P.I./P.D. #5 Name:

Collaborating P.I./P.D. #5 Email Address:

College/Program Area:

Collaborating P.I./P.D. #6 Name:

Collaborating P.I./P.D. #6 Email Address:

College/Program Area:

Collaborating P.I./P.D. #7 Name:

Collaborating P.I./P.D. #7 Email Address:

College/Program Area:

Collaborating P.I./P.D. #8 Name:

Collaborating P.I./P.D. #8 Email Address:

College/Program Area:

Working Title - 255 characters max:

Funder Name:

Is USM a subawardee?: i.e. USM submits a workplan/budget to UNH (Funder) who then submits an application to NSF (Originating Funder)

Yes No

Originating Funder (if different than Funder):

Web Address for RFP (if applicable) or Program Name:

This application is:

Planned Deadline for Full Proposal: (mm/dd/yyyy)

Is deadline flexible?:

Yes No

Estimated Project Start Date: (mm/dd/yyyy)

To:

In addition, this funder requires a:

Letter of Intent/Inquiry Pre-Proposal/White Paper Neither

Due on:

Project Abstract:

Would you like to schedule a meeting to discuss this proposal with your Dean/Director?:

Yes No

Other University Commitments

Check if you will require any of the following:

New Hires, including regular or temporary faculty, staff, or students

Describe:

University commitment to project sustainability or institutionalization beyond the term of the grant award (curriculum or instruction, direct cost commitments, faculty/staff lines, operating and maintenance, etc.)

Describe:

Additional Space (lab, office, etc)

Describe:

Major Equipment

Describe:

Construction or renovation

Describe:

Research Integrity

Check if you will be using any of the following:

Human subjects - For more information see Office of Research Integrity and Outreach

Animal subjects - For more information see Institutional Animal Care and Use Committee

Working with (a) Recombinant DNA, (b) human blood, body fluids, tissues, or (c) agents infectious to humans, animals or plants - For more information see Institutional Biosafety Committee

Protected health information (PHI) - For more information see USM HIPAA Policy

Financial Conflict of Interest

PLEASE NOTE: If you and all key personnel are not in compliance with the FCOI policy prior to the submission date, you will not be able to submit a proposal to any sponsor.

Check here if you, as PI, and all persons who would act as project director under this proposal:

Have filed a Disclosure of Financial Interests Form with the Office of Research Integrity and Outreach (ORIO), and reviewed and updated your filing within the last twelve (12) months.

Have completed Financial Conflict of Interest training within the last four years.

For more information see Financial Conflict of Interest.

Safe Harbor

Research type:

Basic research Applied research

Basic research is scientific investigation that involves the generation of new knowledge or development of new theories; its results often cannot be applied directly to specific clinical situations.

Applied research is scientific investigations conducted to answer specific clinical questions or solve practice-related problems.

All or part of this project will be conducted in:

Science Building, Wing C

Wishcamper Building

Research Service Center

Intent to Propose

Budget

Other University Commitments

Research Integrity

Financial Conflict of Interest

Safe Harbor