Tennessee State University
RESEARCH AWARD ROUTING AND APPROVAL FORM
(All spaces must be completed.)
RESEARCH AGENCY INFORMATION
Agency
Contact Person
Address
E-mail
Name:
Phone:
Fax:
RECEIVING DEPARTMENT
Primary
Department
Principal
Investigator
PI Email
Name:
Phone:
Fax:
Name:
Phone:
Fax:
RESEARCH AWARD DESCRIPTION/INFORMATION
Purpose of
Research Award
(Brief description)
Term of Award
Award Amount
Award Monitor or
Program Officer
Type of Funds
Type of Award
(Check all that apply)
Attachment
Checklist
(Check all attached)
Start Date:
End Date:
$
Name:
Phone:
 Grant Funds/Federal
 Grant Funds/Foundation
 Other Write in:






Research Basic
Research Applied
Sub-Recipient Award
Use of Campus Facility
Clinical Affiliation
Program Evaluation
Fax:
 Grant Funds/State
 USDA Formula Funding (1890)






Workshop/Seminar
Instrumentation/Infrastructure
Public Service/Outreach
Amendment/Renewal
No-Cost Extension
Research Extension Services
 Research Award/Agreement Letter
 Restricted Project Summary/BudgetForm
 Grant Funds/Corporation
 Title III
 Academic Support
 Instruction
 Student Services
 Scholarship/Fellowship
 Other
Write in:
 Any support document(s) available related to
this award.
RESEARCH AWARD CERTIFICATION & APPROVALS
I certify that I have read the attached Research Award Letter/Notice/Fact Sheet and I am in agreement with TSU formally accepting
this research award subject to terms and conditions.
Signature:
Date:
Principal Print Name:
Investigator
Print Name:
Signature:
Date:
Print Name:
Signature:
Date:
Print Name:
Signature:
Date:
Print Name:
Signature:
Date:
Department Head
Dean/Director
Director of Sponsored
Research
Chief Research
Officer
TSU/RSP.12/2014