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Penn CVI: Cardiology Grant Registration Form

Instructions
• Please complete this form and click on the SUBMIT button below.
• Someone will contact you regarding your submission within two business days.
• Please read this document before submitting a request.

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Prinicipal Investigator Information


Proposal Information

Sponsor Name:*

Title:*

Funding Mechanism:* (RO1, PO1, SCOR, Industry)

Program Announcement # [please provide number if available]

Grant Type:*      New       Resubmission       Non-Competing Renewal

Project Length:* (years)

Total Costs: $      Year 01: $      All Years: $

Indirect Cost Rate:
• Federal Overhead Rate » 57%  (July 2005-June 2007); 57.5% (July 2007-June 2008)
• Clinical Trial Overhead Rate » 26%
• NIH R or T » 8%
• Industry/Sponsored Research Non-Clinical » 59.9%

Sponsor-Mandated:*      Other: (specify)

Sub-Contracts:*

Project Description:* (brief 1 - 2 sentences)

Project Information
Application Submission Date:* [ mm/dd/yy ]
Anticipated Funding Date:* [ mm/dd/yy ]
Anticipated Project Start Date:* [ mm/dd/yy ]
Form Confirmation