Request for Approval to Conduct Research Away from HHMI Form
Investigators who are considering conducting research outside of their HHMI host institution should review HHMI’s Research at Institutions Other Than the Host Institution . You should use this form to request HHMI’s review of any proposal to conduct research at another institution under a second lab or
Visiting Researcher Arrangement, in accordance with the terms of the policy. If you are requesting approval for a Sabbatical Leave, please use HHMI’s Request for Approval to Take Sabbatical Leave
Form . We ask that you discuss the proposal with your Scientific Officer six (6) to nine (9) months in advance, and then send the completed form to your Scientific Officer at least three (3) months before the proposed start date for research at the other institution. We urge you to determine as early as possible whether you and/or HHMI will be asked to sign an agreement covering your research at a location other than your host institution. You should send any such agreement to your HHMI attorney at least three (3) months before the proposed start date of your research at the other location. Please direct any questions to your Scientific Officer or HHMI attorney .
Please submit the following documents with this request:

A copy of correspondence from your Dean, the Chair of your department, or an equivalent position at your host institution approving the proposed arrangement, and
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A copy of correspondence from an authorized representative of the other institution approving the proposed arrangement.
HHMI Approval Process:
HHMI will review your responses on this form and inform you whether HHMI approves the proposed arrangement in concept. This preliminary approval will precede HHMI’s review of any required agreement covering your prop osal to conduct research at another location. You will receive HHMI’s final approval of your proposal by email from HHMI’s Vice President and Chief Scientific Officer following HHMI’s review and approval of any required agreement.
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1. Investigator Name:
2. Type of proposed arrangement (please refer to the Research at Institutions Other Than the Host
Institution policy for an explanation of key terms:
Second Lab
Visiting Researcher Arrangement
3. Institutional identity and location of other research site:

4. Proposed start date of your research at the other location:
5. Please describe the scientific justification for your request. Please be sure to explain the relationship between the research you expect to conduct away from your host institution and the research in your HHMI lab, as well as the benefits to your research program of conducting research at another location:
6. Expected duration of proposed arrangement (e.g., indefinite, from X date to Y date, recurring activity):
7. Please explain how research at the other location will be funded:
8. Please explain how research at the other location will be staffed and your supervisory responsibilities for this staff:
9. Please describe any non-research activities that you expect to undertake at the other location:
10. What percentage of your research do you expect to conduct at the other location? Investigators are required to spend at least 75% of their professional time on research. Research conducted at your host institution and at the other location count towards this requirement.
11. What percentage of your total professional time do you expect to spend at the other location?
Except in the case of approved sabbatical leave, HHMI expects investigators to spend at least
75% of their time at their HHMI lab at their host institution, unless HHMI agrees otherwise.
12. Please describe your plans for managing research in your HHMI lab while you are conducting research at the other location:
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13. Will you receive any financial support from the other institution for non-research expenses (for example, reimbursement for reasonable living expenses)?
Yes
No
If yes, please describe the proposed arrangements for any such financial support:
14. Will the other institution require a written agreement? Note that HHMI has a template agreement that is used for second lab arrangements.
Yes (Please send a copy of the draft agreement to your HHMI attorney .
)
No
Don’t know
Please return your completed form by email to your Scientific Officer at least three (3) months before the proposed start date of the proposed arrangement, and include copies of approvals of the proposed arrangements from your Dean, the Chair of your department, or an equivalent position at your host institution, and from an authorized representative of the other institution.
Form SC-740
July, 2014
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