Fillable Office of Sponsored Programs (OSP) Proposal Transmittal and (Touro College)

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Office of Sponsored Programs (OSP) Proposal Transmittal and (Touro College)

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OSP 7/11/2011 1
TOURO COLLEGE
Office of Sponsored Programs (OSP)
Proposal Transmittal and Approval Form
Type of Proposal
New Project
Non-Competing Continuation
Competing /Renewal
Supplement
****************
Pre-Proposal
Revised Budget (Sponsor Required)
PI Name:
Phone #
Email:
Dept./Program/Center:
Position/Title:
Co-PI Name (s):
Note: Touro College Co-PI’s must complete the Co-PI Proposal Transmittal Supplement Form
School:
Graduate Division
Business
Education
Jewish Studies
Psychology
Social Work
Technology
Health Sciences
Undergraduate Division
Lander College of Arts & Sciences
Lander College for Men
Lander College for Women
New York School of Career & Applied Studies
School of Health Sciences
Touro College Berlin
Touro College Israel
Touro College Los Angeles
Touro College South
Professional
Osteopathic Medicine
Pharmacy
Machon L’Parnasa-IPS
The Jacob D. Fuchsberg Law Center
Address:
Contact Name:
Phone:
Email:
Sponsor Solicitation Number:_____________
Proposed Deadline Day/Time:_____________
Type of Deadline:
Mailing or Receipt
Method of Submission:
Electronic or Paper
Proposed Project Start Date :
Proposed Project End Date:
Research
Demonstration
Public Service
Institutional Training
Individual Fellowship
Facilities/Equipment
Conference
Facilities & Administrative (F&A) Cost Rate(s)
Federal On Campus % (Rate = 51.7%)
Federal Off Campus % (Rate = 18.4%)
Other % (Rate) ____________
Funds
Requested
Direct Cost
F & A Cost
Total Cost
If applicable:
Cost Sharing/
Matching
Mandatory
or
Voluntary
Contributed
Total Project
1
st
______________
Budget Period
______________
______________
______________
______________
2
nd
______________
Budget Period
______________
______________
______________
______________
3
rd
______________
Budget Period
______________
______________
______________
______________
4
th
______________
Budget Period
______________
______________
______________
______________
5
th
______________
Budget Period
______________
______________
______________
______________
Total Project
___________
___________
___________
___________
___________
Proposed Subrecipients Organization(s) or Institution(s):
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
OSP 7/11/2011 2
Principal Investigator’s Special Considerations/Comments to OSP:
COMPLIANCE: Does this project entail the use of:
Human Subjects: Yes No
IRB #1 IRB Health Sciences
IRB Proposal #_______________
Date of
Approval___________ or Pending____________
Animals:
Yes No
Bio-Hazards/
Bio-safety:
Yes No
Radiation Safety:
Yes No
Special Needs:
Space Building________________________ Room _________________
Equipment___________________________ Other______________________
************************************
Principal Investigator: I certify that the above information is true, accurate and complete as of this date. I
accept full responsibility for the conduct of this project and for adhering to all provisions required by the
sponsoring agency and Touro College.
I hereby certify that no conflict of interest is posed by my
undertaking this project if it is selected for funding.
A potential conflict of interest does exist. Please
contact OSP immediately.
Approval Certifications:
_________________________________________________________________________________
Principal Investigator Signature, Printed Name, and Date
*****************************
Department Program Chair: (If required) The attached application is approved. It is within the total program
and academic objectives of the Department. Adequate space is available or planned for the conduct of this
project. The time allocations described therein are realistic.
_________________________________________________________________________________
Department Chair Signature, Printed Name, and Date
*****************************
Dean of School: The proposed project application is approved. If matching funds/cost sharing is required I
will be responsible for assuring that the necessary resources are made available. The information contained
on this form is accurate and correct to the best of my knowledge.
____________________________________________________________________________________
Dean Signature, Printed Name, and Date
*****************************
Office of Sponsored Program Director: The proposed project application is approved.
____________________________________________________________________________________
Sponsored Program Director Signature, Printed Name, and Date
*****************************
Authorized Institutional Official: The proposed project application is approved.
____________________________________________________________________________________
Authorized Institutional Signature, Printed Name, and Date
OSP 7/11/2011 3
TOURO COLLEGE
Office of Sponsored Programs (OSP)
Proposal Transmittal and Approval Form
Touro Co-PI Supplement Form (For each Co-PI)
Type of Proposal
New Project
Non-Competing Continuation
Competing /Renewal
Supplement
****************
Pre-Proposal
Revised Budget (Sponsor Required)
Co-PI Name:
Phone #
Email:
Dept./Program/Center:
Project Title:
School:
Graduate Division
Business
Education
Jewish Studies
Psychology
Social Work
Technology
Health Sciences
Undergraduate Division
Lander College of Arts & Sciences
Lander College for Men
Lander College for Women
New York School of Career & Applied Studies
School of Health Sciences
Touro College Berlin
Touro College Israel
Touro College Los Angeles
Touro College South
Professional
Osteopathic Medicine
Pharmacy
Machon L’Parnasa-IPS
The Jacob D. Fuchsberg Law Center
Touro College PI Name:
Sponsor:
************************************
Approval Certifications:
Co-Principal Investigator: I certify that the above information is true, accurate and complete as of this
date. I accept full responsibility for the conduct of this project and for adhering to all provisions required
by the sponsoring agency and Touro College.
I hereby certify that no conflict of interest is posed by my
undertaking this project if it is selected for funding.
A potential conflict of interest does exist. Please
contact OSP immediately.
_________________________________________________________________________________
Co-Principal Investigator Signature, Printed Name, and Date
*****************************
Department Program Chair: (If required) The attached application is approved. It is within the total
program and academic objectives of the Department. Adequate space is available or planned for the
conduct of this project. The time allocations described therein are realistic.
_________________________________________________________________________________
Department Chair Signature, Printed Name, and Date
*****************************
Dean of School: The proposed project application is approved. If matching funds/cost sharing is required
I will be responsible for assuring that the necessary resources are made available. The information
contained on this form is accurate and correct to the best of my knowledge.
____________________________________________________________________________________
Dean Signature, Printed Name, and Date
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Completed 21 July 2020

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