SCC Application Request Form

Investigators contemplating a research proposal that requires a budget from the SCC and institutional signoff must provide a minimum of one month notification. Dr. Miglioretti and her staff will work with each investigator to establish an administrative timeline with a series of internal deadlines so all investigators are clear about what is needed when.  

Investigators who hear about an enticing grant opportunity with a short timeline (less than 4 weeks) may schedule a “feasibility assessment” meeting with Dr. Miglioretti, who will then determine if support resources are available to meet the deadline.  These processes are effective immediately.  Please e-mail us at scc@ghc.org with any questions.

PI Name: 		
Prime Institution		
Official Project Name		
Common/Short Project Name		
Project Start Date		
Project End Date		
Funding Source/Agency		
Due Date to Agency		
Date Due to Prime Site		
Is this a new application?		
Project Type (extension, new, non-competing continuation, renewal, resubmission, revision/supplement, other)		
Mechanism (e.g., RO1, RO3, U01, etc)		
Maximum Cap for SCC funding (specify if per year or entire project, directs or total)		
If FOA, list number & title:		
Will Group Health receive full F&A? (yes/no)		
Key Words		
Major goals/specific aims		
If possible, list what materials Group Health needs to submit (e.g., full 398 forms, just a cover letter and budget…)		

Please let us know anything else about this grant that you think would be helpful: