TEST PAGE – New Grant Submission Notification Form "*" indicates required fields Title * RequiredName * Required First Last Department Primary Role on Project * Required Principal Investigator Co-Principal Investigator Co-Investigator Project Director Co-Project Director Consultant Other Are there additional CHP personnel to list for this grant? * RequiredIf you mark “yes”, a text box will open up below. Yes No Additional Personnel Details * RequiredIf you selected “Yes”, please list each individual and their specific role (e.g., Smith, John – Project Director).Funding Source Type * Required Internal / UAMS State Federal Foundation Other Grant Category * Required Basic Clinical Community Educational Equipment CHP Seed Grant IPE Other Funding Agency Name * RequiredEstimated Effort * RequiredPlease provide your percentage of effort as the number of hours per week dedicated to this project. Note: 10% effort is equivalent to 4 hours per week. Total Budget (in dollars) * RequiredIs this a sub-contract? * RequiredIf you mark “yes”, a text box will open up below. Yes No Sub-contract Budget (in dollars) * RequiredIs a portion of the faculty member's salary being supported? * RequiredIf “yes”, a text box will open up to allow you to enter a percentage. Yes No Percentage of Salary Support * RequiredSubmission Deadline * Required Month Day Year Anticipated Start Date * Required Month Day Year Anticipated End Date * Required Month Day Year
