Proposal Assistance Request Form

Project Title*

PI Name*

First Last

PI Email*

Department/Institute*

If your project will route through an institute (e.g. Center for Human Identification, Texas Center for Health Disparities), please choose it as your selection instead of your assigned department.

Other Department

Date Due*

MM/DD/YYYY

Preferred Submission Date, if earlier than due date

Solicitation #*

Link to solicitation

What type of grant submission is this?

New submission
Resubmission
Competitive Renewal

Would you like a Preliminary meeting? (Required for first time submission at UNTHSC)

Yes
No

In which stage of the grant writing process are you?

Preliminary stages
Proposal has been initiated in Cayuse or respective submission system
Some elements of the proposal are complete (science and/or administration)
All elements of the proposal are complete

UNTHSC Internal Forms Assistance

Please check the forms with which you will need assistance and/or will be required for this project.

External Proposal Transmittal (EPT) Form
Cost Share Form
F&A Waiver (Due 2 weeks prior to sponsor deadline)
PI Eligibility (Due 2 weeks prior to sponsor deadline)

Subaward/Subreceipient Coordination | HSC is the Prime Institution

Please provide the name and email address of the subrecipients who will be involved on your project. (5 entry max)

Subrecipient Organization	Subrecipient PI Name	Subrecipient PI Email

Subaward/Subreceipient Coordination | HSC is the subrecipient

Please provide the name and email address from the prime institution.

Prime Institution	Prime PI Name	Prime PI Email

Do you have an approved Institutional Animal Care and Use Committee (IACUC) protocol for this project?*

Yes
No

Do you have an approved Institutional Review Board (IRB) protocol for this project?*

Yes
No

HSC Personnel (or Project Position) | Effort | Project Role

Please provide the names and effort of the either the HSC personnel (or the vacant position) who will be involved in your project. (15 entry max)

First and Last Name	Effort %	Project Role (e.g. PI, MPI, Co-I, OSC, Postdocs, GRA, Contact PI)

Consultant(s)

Please provide the name and email address of the consultant(s) who will be involved on your project. Note: A consultant is a non-HSC personnel who will provide advice or services and may participate significantly in the research. (5 entry max)

Consultant Name	Email

Proposal Assistance Request Form

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