Ursinus College
601
E. Main
Street
Collegeville,
Pa
. 19426
ursinus.edu
INTERNAL PROPOSAL FORM
Completion of this form indicates official sanction of the outgoing proposal. Please obtain
signatures on the second page and submit signed form to the Advancement Office five
business days prior to the due date.
Submission Deadline: _____________ Submitted by: Institution  Investigator Electronically? Y  N
P
ROPOSAL DATA (a copy of the proposal must be attached):
Faculty / Principal Investigator: _________________________________________________________________________________________
Project Title: ________________________________________________________________________________________________________
Department: ________________________________________________________________________________________________________
Foundation, Agency, program (e.g.: NSF-MRI, NIH–AREA, Foundation): ________________________________________________________
Is Ursinus College the Prime Recipient of the funds? Y  N If not, who: ____________________________________________
Proposed Start Date of Grant, if awarded:
___________ Proposed End Date of Grant, if awarded: ____________________________________
Proposal:
New Renewal Supplement Resubmission If so, Grantee number: ________________________________
Please list collaborators and/or subcontractors: ____________________________________________________________________________
B
UDGET (You must provide a detailed draft budget)
PI, Key Personnel, and Chair(s) are responsible for adhering to College policies and procedures; accepting responsibility for excess expenditures and disallowed costs;
ensuring all costs incurred are project related and in accordance with any terms, conditions and time frames, and ensuring the technical and reporting requirements of the
project are satisfied.
Proposal Request: $ __________________________
College Match / Cost-Sharing Request: $ __________________________
Project Total $ __________________________
C
OST SHARING: (note: any cost sharing must include an account number to charge cost-sharing and the appropriate sign-off below)
College to supply required cost-sharing. The amount is: $ ________________B__
College to supply voluntary cost-sharing. The amount is: $ _B_________________
College to supply summer student housing. Students per summer: ___________________ Number of weeks _____________
College to supply summer faculty stipend(s). The amount per summer: $ __________________________
This proposal includes a request for academic year release time. (Attach justification, see instructions)
F
ACILITY / EQUIPMENT (where appropriate, attach quotes, plans, and narrative for reference):
Equipment being requested has special installation requirements. Explain: ____________________________________________________
Renovations or modifications will be required.
Construction is a component of this grant.
There will be on-going maintenance costs/service contracts to the college for this equipment. Maintenance costs cannot be direct costs, so
must be borne by the College.
Request for the purchase of special computers, hardware or software. The project budget includes funds for these purchases where allowed.
C
OMPLIANCE AREAS: HUMAN SUBJECTS, LABORATORY ANIMALS, AND HAZARDOUS / RADIOACTIVE MATERIALS:
Human subjects are involved, and approval of the procedures to be employed in this project have been approved or will be approved by the
Institutional Review Board by the time of award. IRB number: ____________________________
Laboratory animals are involved. The project budget includes funds to meet all regulations and requirements, and the procedures to be
employed in this project have been approved or will be approved by the Institutional Animal Care and Use Committee by the time of award.
IACUC number: ____________________________
Hazardous / Radioactive materials or agents are involved. The project budget includes funds for their safe use and disposal. Biosafety
committee number: ____________________________
Are any foreign nationals going to be employed by the grant? < or N
C
ONFLICT OF INTEREST (Completed Form Must Be Attached (link here)):
There is a potential "significant financial interest" related to this project, detailed in the attached.
There is NO Conflict of Interest. The disclosure policy form is signed and attached.
REMARKS: ___________________________________________________________________________________________________
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Account Number(s): ____________________________
Account Number(s): ____________________________
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Ursinus College
601
E. Main
Street
Collegeville,
Pa
. 19426
ursinus.edu
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
P
ROPOSAL ROUTING:
Electronic signatures are acceptable. Signatures should be obtained in order. Advancement Office will sign upon submission of
the grant.
I assure that all of the above information is correct to the best of my knowledge. I certify that statements made on this proposal
form indicate that the proposal is in accord with the academic standards and goals of the originating department, the
institutional policies of the department and Ursinus College, and the policies and/or governing regulations of the sponsoring
agency. I agree that the final proposal may be shared within Ursinus College as a learning tool. I agree to readily supply officers
of the institution with all copies of my reviews, and understand that these may be shared within the college to improve future
proposals.
Ursinus Faculty / PI: ________________________________________________________
Ursinus CoInvestigator(s): ___________________________________________________
The attached proposal has been examined by the officials whose signatures appear below. The principal academic review of the
proposal is the responsibility of the Department Chair and College Dean. These signatures indicate that the signers are familiar
with the proposal, and except as noted and ini
tialed in the remarks section, are satisfied with and responsible for all
commitments in the proposal as they relate to their respective areas (e.g. space, personnel, financial, etc.).
1. Department Chair
Of PI’s department
2. Dean of the College
Or delegate
Academic Affairs
3. Business Officer
Business Office
4. Advancement/
Corporate, Government, and Foundation Relations
Officer
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Ursinus College
601
E. Main
Street
Collegeville,
Pa
. 19426
ursinus.edu
INTERNAL PROPOSAL F ORM INSTRUCTIONS
The following is intended to help you with terminology and grant design. If you have
any questions, please contact Advancement.
Principal Investigator: The individual primarily responsible for the conduct of the project.
Prime/Subrecipient: Indicate whether you are receiving funds that are flowing through another institution/organization, or
whether Ursinus College is the dire
ct recipient of the funds. If the sponsor is federal, indicate the CFDA number, if provided.
Budget:
Personnel Costs: Please list out personnel costs, keeping in mind cost of living increases for multiyear projects
(generally 35%).
Budget: Other Costs: Please explain any significant ‘other’ costs in the budget. Costs that fall under this heading could
be consultants, forhire services, participant inducements, honorariums or other projectrelated costs that are not
equipment.
Budget: Indirect Costs: Please check the fact sheet fo r the current federally negotiated facilities and administration rate.
This refers to a certain sum paid by the fundin
g agency to cover general expenses which are difficult to itemize on a
project basis but which provide services necessary to the success of the project. Such costs include the administration of
the program, libraries and physical plan expenses, use of facilities, lights, heat, accounting, etc. If the agency to which
you are applying does not allow full overhead recovery, you must build the cost s in as direct charges (For example, an
administrative allowance and/or space charge) and obtain approval from your college’s administration. F&A agreement
can be found on the UC Canvas course for college researchers.
Financial Conflict of Interest: Please review the policy. ALL key personnel must have current FCOI disclosure forms on file prior
to submission.
Compliance Areas:
Institutional Review Board policies can be found here.
Institutional Animal Care and Abuse Committee assurance contact can be found here.
Institutional Biosafety Committee contact can be found here.
Cost Sharing:
Release Time: Explain how reassigned time from your teaching obligations is critical to completing the project which you
are proposing. Explain how much release time, which semester, what courses/labs will not be taught, and any other
information. Short paragraph will be sufficient. Attach to this form.
Allowable matching/costsharing on sponsored projects: Costsharing is defined as project costs not paid by the
sponsor of a research project. Costsharing can be mandatory or voluntary. The College is responsible for the financial
accounting of all costs attributable to the project, including costsharing. Therefore, all costsharing contained in
proposal budget estimates must be specifically identified, specified and approved by the Principal Investigator,
department chairperson or appropriate Dean and Advancement before the proposal can be submitted. The source of
shared or matching funding and the category of expenditure (i.e. equipment, travel, student stipend, etc.) must be
detailed and confirmed via appropriate signatures and made a part of the proposal file. Please remember that any
quantifiable cost (mandatory or voluntary) offered in a proposal becomes a legally binding and accountable commitment
of the College upon award and all costs must be allowable project costs under federal rules. Ursinus College discourages
costsharing commitments because such commitments obligate the College to financial and administrative requirements
while constricting the use of limited academic resources in other areas needing support. Costsharing requires the
maintenance of detailed records that are subject to audit and costsharing has the potential to affect negotiated Facility
and Administration (indirect costs) rates.