District of Columbia Center for AIDS Research | The George Washington University

Core Services – Investigator Information

Name

Title

If you selected 'other' please indicate your preferred professional title or add an additional professional title if applicable.

Select the title that most closely describes your primary professional role.

Institution

If you selected 'other' please indicate your institutional affiliation.

Are you a full investigator member?

Yes

Project Information

Project Title

Project Description

Include the proposed use of DC CFAR Core services. (250 word maximum.)

Potential for Future NIH Funding

Describe how the proposed support will lead to future projects or NIH grant applications. (100 word maximum.)

Statement of Work

Provide a statement of work for the requested funds.

Letter of Support

Attach a letter of support from the relevant Core Laboratory/Service Director describing how the services will support the project and the Core Laboratory/Service Director will help future development of the project.

One file only.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Cover Letter

Attach a cover letter signed by the applicant and Department Chair.

Budget Information

Budget Justification

Provide a brief budget justification. (100 word maximum.)

Regulatory Documentation

If applicable, attach relevant regulatory documentation (e.g. IACUC, IRB).
One file only.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Microgrant Quote

Billing Information- Institution Supplying Service

Institution Name

Manager Name

Billing Address (where checks should be mailed)

City/State/Zip

Phone

Investigator Information- Supplying Service

Institution Name

Investigator Name

Phone

The manager of the investigator supplying services has reviewed this request and concurs with the quote provided below.

Yes

Investigator Information- Receiving Service

Institution Name

Investigator Name

Phone

The investigator receiving services has reviewed this request and concurs with the quote provided below.

Yes

Description of Services

Please download the microgrant budget template, fill out, and upload here.
One file only.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.