Routing Form For Submission Of Grant Proposals printable pdf download

(Revised 02/1/2016)

Page 1 of 3

Attachment #2

Northwestern State University of Louisiana

Office of Sponsored Programs (OSP)

ROUTING FORM FOR SUBMISSION OF GRANT PROPOSALS OR

CONTRACTS TO EXTERNAL SPONSORING AGENCIES

(This form is to be used beginning 02/1/16.)

NOTE: For internal use only. Please print or type. Deliver original proposal and forms with signatures to OSP.

Attach a copy of the “Notice of Intent to Develop a Proposal for External Funding” to this Routing Form.

Principal Investigator/Project Director (PI/PD):

PI/PD Telephone Number:

E-Mail Address:

College:

Department:

Other Faculty/Staff Involved:

Proposal Title:

Proposal Purpose:

Sponsoring Agency:

Sponsor Program:

Agency Receipt Deadline:

Location:

Total Requested from Sponsor:

Total Institutional Match (cash and in-kind):$

Program Type:

Competitive

Non-Competitive

Proposal Type:

New

Continuation

Renewal

Supplement

Award Received

NOTE: Responses may require approvals and/or documentation

YES

Does this proposal obligate the University for cost-sharing?

Are new positions requested?

Is re-assigned time for faculty or administrative personnel requested?

Is computer equipment, software, or networking service requested?

Will building or utility renovations be needed?

Is board review (e.g., Human Subjects, Animal Subjects, Hazardous Materials) required?

Is the sponsor asked to pay indirect costs? If yes,

% of

budget. If no, attach documentation of

sponsor’s policy to this effect. (See attached pages from RFP.)

Are cost sharing/matching, enhancement analysis, and indirect-cost distribution forms attached?

Will unbudgeted funds be required?

AUTHORIZATIONS:

Signatures below certify that the referenced proposal has been reviewed and approved by that

institutional representative relative to goals, mission, policies, and commitment of fiscal and

personnel resources of that unit of the University. Signatures further certify that, from their own

institutional perspective, the proposal is an efficient and economical use of University resources.

1. PI/PD:_____________________________________________________________________________Date:_________________

***The need for approval #3 must be determined in consultation with Department Head.***

***PI/PD is responsible for obtaining signatures #1 through #6.***

2. Physical Plant: ___________________________________________________________________

Date:________________

3. Institutional Review Board (if applicable):_____________________________________________ Date:_________________

4. Department Head:____________________________________________________________________Date:_________________

My signature also indicates agreement with the PI/PD’s assessment of the need for the review and approval of the IRB.

5. Information Systems:__________________________________________________________________Date:_________________

6. Program Dean or Non-Academic Vice President:___________________________________________ Date:_________________

***Approvals #7 – 10 will be obtained by the Office of Sponsored Programs***

7. Office of Sponsored Programs:__________________________________________________________ Date:________________

8. Vice President for Business Affairs:_______________________________________________________ Date:_______________

9. Provost and Vice President for Academic Affairs:____________________________________________ Date:_____________

10. VP for Technology, Innovation and Economic Development:__________________________________ Date:_______________

Routing Form For Submission Of Grant Proposals

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