APPLICATION FOR SCI TEAM SCIENTIST GRANT (TSG) AWARD
Submission Deadline: Monday, April 25, 2016 by 4:30 p.m.
Directions: ALL of the information requested must be supplied. Electronic submission is required (in one, collated PDF file) and must be sent to
Theresa Casson at tcasson@siumed.edu.
PRINCIPAL INVESTIGATOR:
Typed Name:
Signature:
DEPARTMENT:
% effort for this project:
MAIL CODE & PHONE NUMBER (if Springfield or COMPLETE ADDRESS IF CARBONDALE):
TITLE OF PROJECT/PROPOSAL:
CO-INVESTIGATORS:
SIGNATURES:
DEPARTMENTS:
% effort for this project:
A.
B.
C.
D.
2 YEAR TOTAL BUDGET REQUESTED ($50K/year max):
PROTOCOL APPROVALS (check appropriate box(es):
SCRIHS
YES
NO
PENDING
LACUC/IACUC
YES
NO
PENDING
ICSC
YES
NO
PENDING
RCC
YES
NO
PENDING
PROTOCOL NUMBER/APPROVAL DATE:
All necessary protocol approvals must be secured before grant monies can be made available.
Check box to attest:
SCI Team
Submission of TSG application affirms that PI/Co-PI/collaborator(s): meet eligibility criteria
Scientist
for funding, understand that one aspect of evaluation is potential to secure future external
Grant (TSG) funding for the project, and acknowledge that a requirement of the award is submission of
application(s) to secure external funding within one year of completing the TSG award.