PETITION TO CONDUCT RESTRICTED, PROPRIETARY, OR CLASSIFIED RESEARCH INVOLVING
UNIVERSITY RESOURCES
1. Project title:
2. Principal Investigator/Project Director:
Tenured faculty?
Department:
Yes
No If no, describe status:
3. Co-Principal Investigator(s)/Co-Project Director(s) (list all):
Tenured faculty?
Yes
Department(s):
No If no, describe status:
If more than one Co-investigator/director, indicate whether or not each are tenured
faculty and, if they are not, a description of their status:
4. Will postdoctoral researchers work on this project?
5. Will students work on this project?
Yes
Yes
No
No
6. Sponsoring Agency:
7. Proposed funding level:
8. Beginning and ending dates of the proposed research (also specify the total period and portion
involving classified, proprietary, or restricted research if not the entire period):
9. The location of the proposed research:
10. Time deadlines for the proposal:
or contract under negotiation
(check box)
11. Unclassified summary of the proposed research expressed in non-technical terms and suitable
for public dissemination and understanding. Petitioners are advised that the diverse expertise
of FCRPCR member reflects a wide range of disciplines and thus may not overlap with those of
the petitioner.
12. The intellectual content of the proposed research. That is, the extent to which the research may
lead to significant new knowledge and the importance to the University’s principal mission of
creating knowledge and disseminating it to students.
13. The relationships between the proposed research and the openness of the academic
environment. Specifically,
1 January 2014
a. The extent and duration of special security arrangements (if applicable):
b. The extent to which portions of the campus will have restricted access:
c. The extent to which students and faculty involved in the research will be allowed to
discuss their results with students and faculty not involved in the research:
d. The restrictions that will be applied to publication of results:
e. Is any technology/material export controlled? Yes
No
NOTE: By acceptance of restrictions, the project no longer qualifies for the
Fundamental Research Exemption from export controls. Contact exportco@uccs.edu
with any export control questions
14. The impact of the proposed research on the resources of the University (funds, equipment,
personnel, space, etc):
a. The extent to which the research project will contribute new resources that can be
applied to unclassified or unrestricted work:
b. The extent to which the research project will require the dedication of resources that
would otherwise be available for unclassified or unrestricted work:
15. Describe student, postdoctoral researcher and/or non-tenured faculty involvement in the
proposed research; including a detailed contingency plan that ensures timely completion of
student degree requirements and the ability to publish study results critical to career
advancement:
I certify the information contained herein is correct and all applicable information has been disclosed.
I will report any changes to the Office of Sponsored Programs, which may require my request to be
reviewed again by the Restricted, Proprietary and Classified Research Committee.
Requested by:
________________________________________________
Signature of Principal Investigator/ Project Director
Concur with request:
1 January 2014
___________________________________________________
Chair
___________________________________________________
Dean/Vice Chancellor
1 January 2014
PI/PD: ________________________
Sponsor: _______________________
OSP #________
_____________________________________________________________________________________
FOR OPS USE ONLY:
Restricted
Proprietary
Classified
Recommended for
approval or
disapproval by the Restricted, Proprietary and Classified
Research Committee on ___________ (insert date)
Restricted and or Proprietary:
Approved
Disapproved
__________________________________________________
Kelli Klebe
Associate Vice Chancellor for Research and Faculty Development
____________
Date
Classified
Approved
Disapproved
___________________________________________________
Pamela Shockley-Zalabak
Chancellor
1 January 2014
____________
Date