PalmerCollege of Chiropractic

Form for Approval of Grant and Contract Applications

Grant Routing Form.doc; Version June, 2006

Title:

Principal Investigator:

Other Palmer Key Personnel:

Funding agency:

Application due date: Resubmission?

Proposed start and end dates:

Direct costs and F&A requested for first year:

Direct costs and F&A requested for all years:

Is cost sharing required or recommended? If so, indicate cost per year:

Will this grant/contract require Palmer to add employees? If so, to what extent (% FTE and compensation cost) will these positions be funded by the grant?

Has/will the duration of the positions be limited to this grant?

Has(Will) the duration been(be) formally communicated to the employee?

IRB approval required? Animal care and use approval required?

If subcontractors will be used, indicate organization, key personnel, subcontract costs by year:

Does any faculty, staff, or student involved in this project have any interests that could give rise to a conflict of interest? Explain:

I certify that the information submitted within this application is true, complete and accurate to the best of my knowledge; any false, fictitious or fraudulent statements or claims may subject the PI to criminal, civil or administrative penalties; and I agree to accept responsibility for the scientific conduct of the project and to provide the required progress reports if a grant is awarded as a result of this application.

Principal Investigator: ______Date______

Approval Signatures:

VP for Research/Chief Academic Officer:______

Chief Financial Officer: ______

Compliance Officer:______

Date Approved by Research Review: ______

Process for Completing the Form for Approval

of Grant and Contract Applications

The Principal Investigator (PI) must complete the items on the Approval Form. In addition, the PI must attach to the form an abstract describing the project; a description of the specific aims, background and significance, preliminary studies, and project methods; and a detailed budget. In most cases, a copy of the funding agency’s required application form is appropriate for Palmer’s internal review.

The completed Approval Form plus the attachments shall be submitted to the relevant department head for approval.

The Principal Investigator will be responsible for circulating the Approval Form and attachments to the other required signatories at least 10 working days in advance of the due date for submitting the application to the funding agency.

The signatories will exercise due diligence and timeliness in reviewing the application so that issues or questions that arise can be addressed by the Principal Investigator or department head in time to effect revisions of the application prior to submission. Review and final approval by the Research Review Group shall be completed at least 24 hours prior to the application due date unless serious concerns are raised that would preclude submission of the application.

When all approvals are obtained, the PI is authorized to submit the application by hard-copy or electronic protocols as required by the funding agency.

The original signed Approval Form will be kept with the official grant file. Copies of the signed form will be kept with the Chief Financial Officer, and in the operating project files kept by the research administrator, the department head, and the Principal Investigator.

Grant Routing Form.doc