FEDERAL SECURITY AGENd
    PUBLIC HEALTH SERVICE .
NATIONAL INSTJTUTES OF HEALTH

        APPLICATION FOR RESEARCH GRANT 1

PUBLIC HEALTH SERVICE        oMQ?-~)

NATIONAL INSTITUTES OF HEALTH      Rec.Z-U-52        Date

DIVISION OF RESEARCH GRANTS
Bethesda 14, Maryland

Application is hereby made for a grant in the amount of $ d for the period

from   mtambm    1            through         31
             Month        DV         YOU                      Month        DW         YOU
inclusive fnof +o exceed I yearrl for the purpose of conducting a research project on the following subiec):

IBJvo only brJ.f duertptlvo +JtJ.J

TITLE OF
PROJECT     Bbnnfiam ctlc lWh8x%8



NAME OF PRINCIPAL INVESTIOATOR
   awlltea Ildakrrg

TITLE OF PRINCIPAL INVESTIGATOR
  AawflM8 - 8f 4lmmth8

ADDRESS OF PRINCIPAL INVESTIGATOR   lhYp?aMR& ap Qaaefias
                 unirarsity af uieuouein
                   Elsdism6 ~&~acarain

NAME OF FINANCIAL OFFICER                            TITLE OF PINANCIAL OCPI~KR
TO WHOM CHECK SHOULD IIE MAILED

ADDRESS OF FINANCIAL OFFICER
   &8uml Han
   u*waty 8f Yiraanain
  mdiaon 6, W~~uurmin

                      AGREEMENT

It Is understood and agreed by the applicant: (I) That funds granted as a result of this r&test am to be expended
for the purposes set forth herein; (2) that the grant may be revoked in whole or part ,at any time by the Surgeon General
of the Public Health Service, provided that a revocation shall not include any amount obligated previous to the
effective date of the revocation if such obligations were made SOMY for the <purposes set forth in this application;
(2) that all reports of original investigatons supported by any grant made as a result of this request shall acknowledge
such suppor); (4) that if any patentable discoveries or inventions are made in the course of the work aided by any
grant received as a result of this application, the applicant will, in consiieration of such grant, refer to the Surgeon
General of the Public Health Service, for determination, the question of whether such patentable discoveries or inven-
tions shall be patented and the manner of obtaining and diiposing of the proposed patents in order to protect the
public interest.

NAME AND TITLE OF
OFFICIAL AUTHORIZED
TO SION FOR
wJeu0 TyPeI    INRT'ITUTJOL

b&-d)     A. W. PETEZtSON

  PERSONAL SIGNATURE
  mbh ogrwmwt lwst wrry IRe
a&al sJgmatm of tb OActcll wbosa
muw appear8 # ae llw d0ve.l
                      PAaE 1

PHS-398
Rev. 8451


1 (LEAVE BLANK)

BUDGET PROPOSED FOR THE YEAR &%@-I           through
NOTE: Under column entitled "OTHER" indicate funds presently available               BUDGET
or anticipated from other sources including own institution.                    REQUESTED
                                                                 FROM P.H.S.  I      OTHER

PERMANENT EQUIPMENT (/temize~

I                 I
I              I

costs, i.e. 8 percent of

TOTAL FOR THE YEAR     -

ESTIMATE OF FUTURE REQUIREMENTS

Estimate of future requirements applies to funds needed from the Public Health
Service for the years subsequent to the period proposed at -the top of this Rage.
The blanks at the right provide space for requesting four additional years of supper);
any amounts entered should include "overhead" if such is. to be requested. Do not
leave any of these spaces blank-enter one of the following as applicable: The amount
needed, "not applicable," "unknown" or "none". FOR FURTHER INFORMATION:
See detailed instrudions accompanying application forms.

.-

PNS-398
Rev. s-61

PAGE 2


PUBLlC HEALTH SERVtCE SUPPORT: Show previous and current Public Health Service grants supporting this proieck
GRANT NUMBER               TITLE OF PROJECT                       PERIOD OF BUPPORT
PREVIOUS                                513J 1-
w-@-      ihm$&#8 rryt maella                       t8
w721                                h#88* 19%

CURREJ4T

ALL OTHER SUPPOR

    SOURCE
CURReNT
L-v
IartHaa84
"&BWk8N&@
PENDINQ

r. Excluding Public Ho&h Service, but including that from uwn institution, list support from other
' sources for this projoct. If nono, so indicatm.
          TITLE OF PROJECT       1 AMOUNT IPERIOD OF SUPPORT
                                            I              I

            RESEARCH PLAN AND SUPPORTING DATA
On the contiauation pages provided give detatls of the proposed plan sod other ncessary data im
accordance with He outline below. Number each page, We first comtimuatiom page being page 4.
Additional continmatioa pages, if needed, may be requested from the Divisfoa of Research Gramts. See
detailed instructions before preparimg Ms porih of tba application
  I. RESEARCH MAN

k Specific Aim-e a concise statement of the aims of the propored work.
B. Method of Ikcedure-Gii details of your plan ef attack.
C. Significance of this Research-kplain why the results of the proposed work may be important.
D. Facilities Available-Describs ibe general faciliies at your disposal. List the major o hms of
permanent equipment.

2. PREVIOUS WORK DONE ON THIS PROJECT
  hscribe briefly any work you have done to date tha+ is particularly pertinent.
3. PERSONAL PUBLICATIONS

  Cite your most important publiitions on this or dosely related work List no mere than five.
4. RESULTS OBTAINED BY OTHERS

  Summar'- pertinent results to data obtained by &hers ion this problem, citing publications deemed
  pertinent. Select no more than five.
b. BKJGRAPHICAL SKETCHES

Provide brief &etches for All professional personnel selected who are to be actively engaged in this proiect.

PHWT8
8.v. Wl


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                              E-72 (cts) = (3)


1 mm APPLICATION FOR REBEARCA      (contimuoHoa po!H.                  (LEAYE BLANK)-

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4. Rerults obtahed by c&here. The basic a~~peu'~tal fladiage of th%s
wolrtham been oollrfinned ln asosm1 labssator%ee. Additlonelcontributions
nay aleo be icrfbd aa foU.we:

15, Dads, B.D. lps0 NaolPiltreMlify UP the agents of gen4fic rsaoanbinetWn
  in E. toll.  J. Eketo 602 yl?-p3

  6
PAO"

PHS-398
Rev. 8.51


                            7

I                                                PAOC

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