Grant Internal Processing Form

Questions for the internal processing form (Ramses)

Fill this form out, follow instructions, etc.

Principal Investigator

Funding Agency

Budget type:


Due date:  
/ /  

Project

Dates of Project
start date
/ /  
end date
/ /  

Subcontractor

1. Does this proposal involve subcontracts?  


2. If yes, please list subcontractor(s) below:
3. If yes, does the proposed subcontractor's scope of work include the use of animal subjects?


4. If yes, does the proposed subcontractor's scope of work include the use of human subjects?


Before responding below, for DHHS please check the Letter of Intent AND the Federal Demonstration Partnership (FDP) website to verify that the proposed subcontractor has a compliant conflict of interest policy. For NSF, please check the Letter of Intent to verify that the proposed subcontractor has a conflict of interest policy that complies with Department of Health and Human Services (DHHS) or National Science Foundation (NSF) standards, as applicable to this subaward.
5. If yes, does the proposed subcontractor have a conflict of interest policy that complies with Department of Health and Human Services (DHHS) or National Science Foundation (NSF) standards, as applicable to this subaward?


Human Subjects

1. Does this research involve HUMAN SUBJECTS?   If NO, proceed to ANIMAL SUBJECTS section.


2. If YES, has your research team submitted an application for IRB approval? If YES, fill in IRB number. If NO, answer question 4 below.


4. * If you have not submitted an application for IRB approval, please check reasons below:

Animal Subjects

1. Does this research involve ANIMAL SUBJECTS?   (NOTE: This includes any animal work conducted at UNC-CH, other domestic institutions, and/or foreign institutions. Please take into account any animal work performed at collaborating sites, fee-for-service arrangements, and/or subcontracts.) If NO, proceed to Research Material section below.


2. If YES, is animal work being conducted at UNC-CH as part of this research? If YES, complete Sections 3-8 below. If NO, skip to Section 7 below.


3. If YES, has your research team submitted an application for IACUC approval? If YES, complete Sections 4 and 5 below. If NO, skip to Section 6 below.


6. If no IACUC application, please indicate which of the below applies:


7. Is animal work being conducted at institutions other than UNC-CH as part of this research? If YES, complete Sections 8-15 below. If NO, skip to Research Materials section below.


8. Domestic Institutions: Check all that apply. Subcontract = Any external organization that performs grant-supported research activities involving animal subjects under a contract arrangement; Fee-for-service = Any entity conducting animal work for reimbursement; Collaborating Site = Any site conducting animal work that will not be under a subcontract or fee-for-service, i.e. no funds are requested
9. Foreign Institutions: Check all that apply

Research Materials

1. Radioactive material?


2. Potential biological hazards (viruses, recombinant DNA, etc.)?


3. Chemical hazards (poisons, explosives, reagents, flammables, carcinogens, etc.)?


4. Use of botulinum neurotoxins, botulinum neurotoxin producing species of Clostridium, or preparations or pharmaceuticals containing botulinum neurotoxins?


5. Materials provided by the sponsor or any other party?


If the proposal involves any of the above materials, contact the Department of Environment, Health and Safety (DEHS) for required approvals at 962-5507 (email: dehs@unc.edu)

Export Control

Export control web sites have been created to assist with determining whether compliance issues exist. If you have a specific question about export control regulations, please contact Judy Culhane Faubert at faubert@email.unc.edu or visit one of the following export control web sites:
http://research.unc.edu/osr/policies/export_control.php
http://www.unc.edu/depts/legal/newlinks.html

1. Have you signed or been asked to sign a DoD Form 2345 "Militarily Critical Technical Data Agreement" related to this project?  


2. Do you anticipate that the project work may involve sending/transporting/transmitting/carrying any material or equipment related to this project outside the US (examples include: GPS, Biologicals, diagnostic kits, reagents)?


3. Do you anticipate that the project work may involve travel outside the US?


4. Do you anticipate that the project work may involve transmitting funds (through payments, for example) or goods or technology to any of the following countries on the OFAC list? Balkans, Burma, Cuba, Iran, Iraq, Ivory Coast, Lebanon, Liberia, Libya, North Korea, Rep. of Congo, Sudan, Syria and Zimbabwe


5. Some types of research may have export control implications even if all work is conducted in the U.S. Do you anticipate that the project work may involve non-commercial encryption or information security software?


6. Do you anticipate that the project work may involve any equipment, technology, materials or software specifically designed, modified, or adapted (even slightly) for a military purpose that may involve national security?


7. Do you anticipate that the project work may involve any Classified materials, equipment, technology or data?


Intellectual Property

1. Have you disclosed any of this research to the Office of Technology Development?  


If you have not disclosed any of this research, do you think this research has the potential for a patent?


2. Does the research in this proposal involve any filed patents?


3. Does the research in this proposal involve any issued patents?


4. Will this research use any materials obtained from a third party under a transfer agreement granting ownership rights in inventions and/or data out of the use of the material?


5. Will this research use any material, patented or otherwise, which is owned by UNC-CH and licensed to a commercial entity?


6. Is this proposal an SBIR (Small Business Innovative Research Program)?


7. Is this proposal an STTR (Small Business Technology Transfer Program)?


If yes, please answer questions A, B and C below:
A) Will you be the designated Principal Investigator for this project?


B) What is your formal relationship with the applicant organization?
C) Will at least thirty percent (30%) of the work of the STTR be performed by UNC-CH?


Community Engagement

Community Engagement

Community Engagement describes the collaboration between institutions of higher education and their larger communities (local, regional/state, national, global) for the mutually beneficial exchange of knowledge and resources in a context of partnership and reciprocity. The purpose of community engagement is the partnership of college and university knowledge and resources with those of the public and private sectors to enrich scholarship, research, and creative activity; enhance curriculum, teaching and learning; prepare educated, engaged citizens; strengthen democratic values and civic responsibility; address critical societal issues; and contribute to the public good. (Carnegie Foundation for the Advancement of Teaching)

Project Activity: Can some or all of the proposed project activity be considered community engagement?  


Please distribute the percentage of community engaged activity by location. Total must equal 100%
Project Budget: Will some or all of the proposed project budget be used for community engagement?  


Please distribute the percentage of community engaged budget by location. Total must equal 100%
Locations of Budget Expenditures

Locations of Budget Expenditures

Please indicate the locations where your research will occur and assign a percentage to each location. Percentages should reflect the portion of the total budget which would expended in that location.

UNC-CH Locations: If any sponsored activities occur on campus, please enter below each on-campus location and the percentage of work that will be done there:

In-State County Locations: If any sponsored activities occur in-state, please enter below each in-state county location and the percentage of work that will be done there:

Note: If activities occur on campus, do not also add Orange County as a separate In-State location.

Out-of-State Locations: If any sponsored activities occur in other U.S. States outside North Carolina, please enter below each state and the percentage of work that will be done there:

International Locations: If any sponsored activities occur outside of the Unites States, please enter below each location and the percentage of work that will be done there:

Locations Relevant to Your Project

Many projects are associated with a particular geographic location. For example, for projects involving or affecting human or animal populations (collecting new data or analyzing existing data), these geographic locations would be where the humans or animals live. For environmental studies, these geographic locations would include the site(s) of the phenomenon under study. Please add geographic location(s) relevant to your project below. Ensuring that all pertinent locations are reflected allows UNC-CH to accurately map the areas relevant to this project.

Additional Notes