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* 1. Principal Investigator's Name (Last, First)

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* 2. Project/Study title

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* 3. Funding Agency

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* 4. If funded by the NIH, Institute and Grant number

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* 5. Local Collaborator

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* 6. Ending the Epidemic Pillar(s)

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* 7. Study start Date

Date

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* 8. If completed, Study End Date

Date

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* 9. If applicable, Publications (List PMID)/Links to results

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* 10. If applicable, Presentations to external audiences

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* 11. If applicable, dissemination to community partners and/or stakeholders

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* 12. Please describe in Lay Language, in 2-3 sentences, why this study is important to the community

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* 13. If applicable, Please describe in Lay Language, in 2-3 sentences, the results of your study.

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