Applicant Contact Information

* 1. First Name

* 2. Last Name

* 3. Institution Name

* 4. Researcher Title

* 5. Department

* 6. Address

Mentor/Principal Investigator Contact Information

* 7. First Name

* 8. Last Name

* 9. Institution Name

* 10. Researcher Title

* 11. Department

* 12. Address

Project Information

* 13. Project Title

* 14. Are you currently working at an HDSA Center of Excellence?

* 15. If yes, provide details in box below.

* 16. Are you currently collaborating with or have you identified a potential HDSA Center of Excellence for collaboration on this project?

* 17. If yes, provide details in box below.

* 18. Do you need assistance identifying a willing HDSA Center of Excellence Director as a collaborator?

* 19. Will Institutional Review Board (IRB) or Institutional Animal Care and Use Committee (IACUC) approval(s) be needed before the proposed research can commence?

* 20. If yes, please provide details to when approval can be expected.

Project Proposal
The project proposal is a Microsoft Word document of 1000 words or less. In the proposal, you must include the following information: 1. A short summary that outlines the intended research and specifically states how the results adhere to the Statement of Need listed in the Request for Proposal. 2. Background and/or Preliminary Data 3. Specific Aims 4. Experimental Plan, including time required to complete studies 5. Qualifications or the researcher/applicant Completed LOIs to be directed to George Yohrling (gyohrling@hdsa.org) Email George Yohrling

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