PI Proposal Form

PI Proposal Form

Center for Gastrointestinal Biology and Disease Principal Investigator Proposal Routing/Checklist

Please complete the form below and click 'Submit'.

Agreement Type
Please specify type of Agreement  


Principal Investigator
Funding Agency
Project Start Date  
/ /  
Project End Date  
/ /  
Is this a federal submission?  


Agency Deadline Date  
/ /  
Research Subjects
Will human subjects be involved?  


Have you submitted IRB application?


Will animal subjects be involved?  


Research Materials
Will radioactive materials be involved?  


Will potential biological hazards (viruses, recombinant DNA, etc.) be involved?  


Will chemical hazards (poisons, explosives, reagents, flammables, carcinogens, etc.) be involved?  


Will botulinum neurotoxins, botulinum neurotoxin producing species of clostridium, or preparations of pharmaceuticals containing botulinum neurotoxins be involved?  


If yes to the above, contact the Department of Environment, Health and Safety (DEHS) for required approvals at 919-962-5507 or E-Mail: dehs@unc.edu
Does this study involve the use of materials provided by the sponsor or any other party?  


Export Control
Do you anticipate that the project work may involve:
b) Travel outside the US?


c) Transmitting funds (through payments, for example) or goods or technology to countries on the OFAC list*


*OFAC list includes the following countries: Balkans, Belarus, Burma, Cuba, Democratic Republic of Congo, Iran, Iraq, Ivory Coast, Lebanon, Liberia, Libya, North Korea, Somalia, Sudan, Syria, Yemen or Zimbabwe
3. Some types of research may have export control implications even if all work is conducted within the US. Do you anticipate that the project may involve:
a) Non-commercial encryption or information security software?


b) Any equipment, technology, materials or software specifically designed, modified, or adapted (even slightly) for a military purpose or that may involve national security?


c) Any classified materials, equipment, technology or data?


Intellectual Property
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?


Does the research in this proposal involve any filed patents?  


Does the research in this proposal involve any issued patents?  


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


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


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


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


If yes, please enter the following information:
Will you be the designated Principal Investigator for this Project?


Will at least thirty percent (30%) of the work of the STTR be performed by UNC-CH?


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?  


What percentage of the overall project activity meets the definition of 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?  


What percentage of the overall project budget meets the definition of community engagement?
Please distribute the percentage of community engaged budget by location. Total must be 100%
Project Information
I give permission to include this abstract in the Research Abstracts Database (RAD)  


F&A Rates  




Will F&A be shared with other Depts?


Sub-Contracts
Will there be sub-contracts on this proposal?  


If sub-contracts on this proposal, provide information below for the SUB-CONTRACTING INSTITUTION
Are there any other budgetary issues that need to be discussed, or other questions that need to be answered?  


If this is a clinical trial, do you have a coordinator who will complete Ramses, Alice and CRMS system forms?