TNS Grant Request

Questions? Contact the TNS office at 512.370.1532 or send an email to ky.camero@texmed.org

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* 1. Full Name:

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* 2. Address

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* 3. You are:

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* 4. If you are a medical student, are you a member of SIGN?

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* 5. If you are a medical student or resident, do you have a faculty mentor?

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* 6. If you answered "yes" to question 5, please list your faculty mentor.
If "no", type NA

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* 7. Entity or Sponsoring Institution

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* 8. Project Title

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* 9. Scope of Research

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* 10. Project Description

(Briefly describe Background, Aims, Research Plan, Future Directions--do not exceed 500 words in total) 

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* 11. Project Budget: Insert here  
(please use simplistic format/spreadsheets are hard to review)

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* 12. Do you have additional funding for this project?

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* 13. References

(Limit is 10)

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