Research Presentation Creative Production Service Project
Title:
CUHSR Approval Number:
Principal Investigator/Author: Rank/Title:
Department: Campus Phone:
Co-Investigators/Co-Authors:
Amount Requested from CRS: $
OTHER FUNDING (if applicable)
Amount Applied For: $ From: Amount Granted: $
Amount Applied For: $ From: Amount Granted: $
Amount Applied For: $ From: Amount Granted: $
Previous Funds Received from CRS? (Y/N) Date: Amount Granted: $
Title of Previous Project(s):
-------Attach Documentation of Publication from Previous Project
and CRS Funding Report if not already submitted -------
For Research Proposals Only: Human Subjects or Research Animals? (Y/N)
-------Attach Human Subjects or Animal Approval Form-------
Intent to Present at National/International Professional Meetings? (Y/N)
List Probable Conference(s):
Intent to Publish? (Y/N) Expected Date of Submittal:
List Probable Journal(s):
Completion of Creative Production or Service Project Date
Signature: Principal Investigator Date
Signature: Co-Investigator(s) Date
Signature: Department Chair Date
APPROVAL
Signature: Director, CRS Date Amount $
Signature: Dean, EHS Date Amount $
---Complete the Appropriate Corresponding Checklist---
