Research Proposal Request Step 1 of 3 33% Name(Required) First Last Email(Required) General InformationType of Submission(Required)NewResubmissionRenewalSupplementDid any patents or inventions result from the original award? Yes No Please Provide Federal IdentifierPlease Provide Federal IdentifierProposal Title(Required)Short TitleSponsor(Required)Lead Site SponsorSubmission Deadline(Required) MM slash DD slash YYYY Proposed Begin Date(Required) MM slash DD slash YYYY Proposed End Date(Required) MM slash DD slash YYYY RFA/FOA Title(Required)RFA/FOA URL(Required)Keywords(Required)PI Effort Required(Required)Are you the PI submitting this proposal request?(Required) Yes No Name(Required) First Last UFID(Required)Department(Required)Does the proposed project involve any items that require either institutional approval or commitment?(Required) Yes No Will you require institutional approval or commitment for space (renovation, alteration, or addition)?(Required) Yes No Will you require institutional approval or commitment to purchase or install major equipment?(Required) Yes No Will you require institutional approval or commitment for other resources required but not requested (e.g. graduate student tuition, computing services)?(Required) Yes No Will the proposed project generate Program Income (revenue)?(Required) Yes No Please explain(Required)Is proprietary/privileged information included in the proposal/application?(Required) Yes No Please explain:(Required) Personnel InformationUF PersonnelWill the proposal include any UF personnel other than the PI?(Required) Yes No Individual(s) [Please fill in each box](Required)Full NameProject Role% of EffortKey Personnel (Yes/No)? Add RemoveNon-UF PersonnelWill the proposal include a subaward, consultant or collaborator from another organization?(Required) Yes No Individual(s) [Please fill in each box](Required)Full NameProject Role% of EffortOrganizationEmail AddressKey Personnel (Yes/No)? Add Remove General Compliance InformationDoes the proposed research fall within the scope of, or is it impacted by, current U.S. government policies, regulations, and laws on dual-use research of concern, gain-of-function research, or research involving pathogens with enhanced pandemic potential?(Required) Yes No Will the proposed project involve HUMAN SUBJECTS, including human data or tissue, or collection of data through surveys?(Required) Yes No Yes, but through approved Vendors (ATCC, DSMZ, or dbGaP) Will you use only de-identified* data or tissue?(Required) Yes No * De-identified is either (a) anonymous or (b) coded with a confidentiality agreementWill the proposed project involve human embryonic stem cells?(Required) Yes No What is the IRB status?(Required)Please select…ApprovedPendingExemptNot Yet AppliedPlease provide IRB approval numberIs this work an NIH-defined clinical trial or prospective observational clinical research?(Required) Yes No Is the University of Florida an enrolling-only site under this scope of work?(Required) Yes No Will the proposed project involve Live Vertebrae Animals?(Required) Yes No Are vertebrae animals euthanized?(Required) Yes No Is method consistent with AVMA guidelines?(Required) Yes No What is the IACUC review status?(Required)Please select…ApprovedPendingNot Yet AppliedPlease provide IACUC approval numberGlobal ComplianceConduct project-related travel (you or anyone working on this project) to a location outside the US for more than 2 weeks in any one visit – or more than 1 month over a 12-month period?(Required) Yes No List Travel [Please fill in each box](Required)CountryBegin DateEnd DatePurpose of Travel Add RemoveEstablish any relationships with foreign entities, individuals or consultants, or have any of the work executed by a foreign entity, individual or consultant?(Required) Yes No List Foreign Entities [Please fill in each box](Required)Individual Full NameEntityCountryApprox. BudgetDescription Add RemovePay non-UF personnel salaries, wages or any other compensation (including goods) for any work performed or engagement in activities outside the US?(Required) Yes No This includes field workers, research assistants, government representatives, participant payments, translators, drivers or any other laborers.List Non-UF Salary Payment [Please fill in each box](Required)Individual Full NameEntityCountryApprox. BudgetDescription Add RemoveTransfer, ship, or pack in personal luggage for transfer out of the US any data, items, supplies, equipment or materials purchased by UF OR sponsored project funds?(Required) Yes No List Export Controls [Please fill in each box](Required)Item or Type of ItemCountry Add RemoveInteract with an individual from, ship to, import from, or travel to any of the following countries: China (including Hong Kong), Sudan, Iran, Syria, North Korea, Cuba, Crimea region of Ukraine, Venezuela?(Required) Yes No List Individuals from Restricted Countries [Please fill in each box](Required)Individual Full NameEntityCountryApprox. BudgetDescription Add RemoveOther Compliance QuestionsDoes this project have an actual or potential impact – positive or negative – on the environment?(Required) Yes No Please explain:(Required)If this project has an actual or potential impact on the environment, has an exemption been authorized or an environmental assessment (EA) or environmental impact statement (EIS) been performed? Yes No Please explain:(Required)Is the research performance site designated, or eligible to be designated, as a historic place?(Required) Yes No Do you have any additional information to share about your proposal?Attach any additional documentsMax. file size: 125 MB. Attach any additional documentsMax. file size: 125 MB. Attach any additional documentsMax. file size: 125 MB.
