Research Proposal Abstract Form
ADVERTISEMENT
1
2
3
4
5
6
7
8
9RESEARCH PROPOSAL ABSTRACT FORM
Ohio Department of Mental Health
DMH-RES-617
RESEARCH PROPOSAL ABSTRACT FORM
Ohio Department of Mental Health
DMH-RES-617
Date Submitted
Tax I.D. Number
1. Title of Proposal
2. Applicant Organization/University, College, and Department
3. Principal Investigator (P.I.)
Name
Mailing Address
City, State, Zip
Phone Number
Fax Number
Co-Principal Investigator
Name
Mailing Address
City, State, Zip
Phone Number
Fax Number
Co-Principal Investigator
Name
Mailing Address
City, State, Zip
Phone Number
Fax Number
4. Grants Management Officer
Name
Mailing Address
City, State, Zip
Phone Number
Fax Number
5. Proposed Dates of Entire Project Period
Beginning Date
Completion Date
6. Funds Requested from ODMH for Entire Project Period
$
7. Breakdown of Requested Funds by Fiscal Year (July 1 - June 30)
(a) Funds within First F.Y. or Part of F.Y.
$
Fiscal Year
(b) Funds within Second F.Y. or Part of F.Y.
$
Fiscal Year
(c) Funds within Third F.Y. or Part of F.Y.
$
Fiscal Year
REV. 3/96
Page 1/9
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business