Research Proposal Abstract Form (Page 8 of 9) in pdf

Research Proposal Abstract Form Page 8

RESEARCH PROPOSAL ABSTRACT FORM

Ohio Department of Mental Health

DMH-RES-617

11. Dissemination

Please describe your dissemination plans. Identify where you expect to submit a manuscript for publication and where you expect to present

findings (e.g., professional conferences):

12. Special Arrangements

Describe any special administrative arrangements (e.g., collaboration with investigators from other institutions, community agencies). If

investigators from outside agencies and/or institutions are involved, list their names, affiliations, and the role(s) they will play in this project:

13. Certification and Acceptance

We, the undersigned, certify that the statements herein are true and complete to the best of our knowledge and accept, as to any grant

awarded, the obligations to comply with Department of Mental Health, State of Ohio, terms and conditions in effect at the time of the award.

(Note: One copy of this document must contain original signatures.)

Date

Signature of Principal Investigator and Title

Date

Signature of Grants Management Officer and Title

Date

Signature and Title

Date

Signature and Title

REV. 3/96

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Research Proposal Abstract Form Page 8