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VIRGINIA STATE UNIVERSITY (Virginia State University)

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VIRGINIA STATE UNIVERSITY
Proposal Processing and Approval Form
Type of Document: ( ) New Proposal ( ) Renewal Project Type: ( ) Research ( ) Teaching/Instruction
( ) Re-submission ( ) Other ___________ ( ) Equipment ( ) Service ( ) Other
(Please submit this form along with your proposal)
1. Investigator Data
1A.
Principal Investigator:
Department:
Tel:
Fax:
Co-PI:
Department:
Tel:
Fax:
2. Proposal Data
Proposal Title:
Purpose of Project:
Name of Agency:
Agency Contact Person:
Phone No:
Web site where RFP can be found:
Proposal Deadline Information:
Type of Agency: Federal ( ) S
tate ( ) [check one]
3. Budget Data
3A. Faculty and Staff Participation in Project
Name
% of effort on
project
Salary Paid by
Grant
Summer Salary
Total
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3B. Total Value of Grant by Year: (including IDC) $ ______
Yr 1 - $______ Yr 2 - $______ Yr 3 - $_______ Yr 4 - $_______
Yr 5 - $_______
3C. Indirect Cost Recovery Rate. Does your budget include VSU’s negotiated indirect cost recovery rate of .% of 07'&?
Yes ( ) or No . If not, enter the indirect cost recovery rate here: ___ %_____ GHVFULEHWKHEDVHKHUH
Is the latter rate specified by the agency ( ) or by VSU ( )
7RWDO,'&
Yr 1
- $______ Yr 2 - $______ Yr 3 - $_______ Yr 4 - $_______ Yr 5 - $_______
OSR&P Use Only
Date Proposal Received__________________
Date Proposal Due to ___________________
 Mail  Electronic Submission  Personal Delivery
Potential CFDA #________________
Current Account #____________________
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More Investigator Data is on the continuation pg.
Private/for profit
Non-profit/foundation
More Budget Data is on the continuation pg.
$0
Proposal Processing and Approval Form
Page 2
3D. Current Funding & Percentage (OSR&P Use Only)
3E. University Contributions (Cash-Match, In-Kind Contribution or Cost Share) _______________________
3F. For cash contributions, Dept. Account Number and Account Manager signature is required
__________________ _______________________________
BANNER Acct. No. Account Manager Signature
4. Special Issues
4A. Subcontractor:
Name & Contract Amount:
4B.
Does this project involve use of the following? Please, check all that apply:
( ) Human Subjects ( ) Animal Subjects ( ) Hazardous Chemicals ( ) Radioactive Materials
( ) Biohazards ( ) Subcontractors ( ) Collaborations
If yes to any, please explain
4C. Is space available? Yes ( ) No ( ) If yes, Building__________________________
4D. Research Equipment: Does project require acquisition of equipment? Yes ( ) No ( ) . If yes, are funds included in the budget of the
proposal? Yes ( ) No ( ) If not, indica
te
cost $_____________
Installation of Equipment: Will acquisition of major equipment items require installation and building modification at a cost to
the University? Yes ( ) No ( ); To the project? Yes ( ) No ( ); If yes, estimate cost $_______________
4E. Will students participate in the project? Yes ( ) No ( ) If yes, identify the levels and numbers:
Undergraduate Level: Senior ( ) Junior ( ) Sophomore ( ) Freshmen ( ) ; Indicate the number of students
Graduate Level ( ) Indicate the number of students ____
5. Administrative Approval
A. ________________________________________
Chairperson of the Principal Investigator’s Department
Date ___________________
OSR&P Use Only:
B. ___________________________________________ C. ______________________________________
Dean of the Principal Investigator ’s School
Date ___________________
Provost/VP for Academic Affairs
Date
_________________
Proposal Processing and Approval Form Rev. 0/201
Cost to Project
Cost to University
Charlene Wyche, Director, Sponsored Research
Proposal Processing and Approval Form Continuation Page
1. Investigator Data (continuation page)
1A.
Principal Investigator #2:
Department:
Tel:
Fax:
Principal Investigator #3:
Department:
Tel:
Fax:
Co-PI #2:
Department:
Tel:
Fax:
Co-PI #3:
Department:
Tel:
Fax:
Co-PI #4:
Department:
Tel:
Fax:
3. Budget Data (continuation page)
3A. Faculty and Staff Participation in Project
Name
% of effort on
project
Salary Paid by
Grant
Summer Salary Total
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VIRGINIA STATE UNIVERSITY (Virginia State University)

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Completed 1 September 2020

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