Proposal Intake Form (IGH)

Please provide as many details as possible about your proposal to help us initiate your proposal.

Name Name First Last
Email
Sponsor
Sponsor Due Date Sponsor Due Date / MM / DD YYYY
Funding opportunity
Project Title (draft is fine)
Submission Type

Submission Type New Resubmission Renewal Other Other
Is Northwestern the prime (submitting directly to the sponsor)?

Is Northwestern the prime (submitting directly to the sponsor)? Yes No If no, who is the prime institution? If no, who is the prime institution?
Are there any subcontracts?

Are there any subcontracts? Yes No Unsure If yes, please identify which site(s): If yes, please identify which site(s):
Human Subjects?

Human Subjects? Yes Yes (exempt) Yes (delayed onset (D43)) No
Vertebrate animals?

Vertebrate animals? Yes No
Please include any additional information or background to help us expedite this request.
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