Agenda - 06-02-2004-7a - Laserfiche WebLink

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Pnnotpa] Madeleine Cmmmet Title: Educational Resources m Chapel HiiUCatrboro end Change County~rl Investigator: ___ School_Systems: Description --/~~„' t2. Does the proposal involve Subcontractors (for which funds are requested)? No12. a. If yes, please list the names below and attach the following Subcontract information to the IPF: 1) Statement of Work, 2) budget, 3) budget justification, 4) If NIB, include the 398 and 2590 face page and checklist, S) ff not NIIi, then attach a letter from subcontractor signed by an authorized official 13. Does the proposal require any equipment ^ personnel (~ or space ^ in addition to existing resources? No 13 _ J 2. If yes, have the appropriate officers of the institution agreed that it can be provided within the limits YeslNo 13a. of the funds being requested? b. If the proposal requires the purchase of equipment, have you determined the equipment Yes/No 13b. is not available at your campus for this project? 14. Does this project involve carrying out classified research on campus or require a security clearance for No 14. UNC-CH personnel? Ifyes, contact the UNC-CH Vice-Chancellor for Research and Economic Deve]opment (Press FI for contact i'.nformation) I5. Benefits to North Carolina a. All sponsored Programs provide benefits in the sense of institutiotial support, employment, training of students, and the economic multiplier effect (i.e., university, employee, student, and visitor spending). However, this question addresses projects that emphasize benefits to North Carolina citizens beyond the immediate university community. In particular, will this proposal (Please chalk all that apply): i. ®Affect economic development in North Carolina? ii. ®Provide community services in North Carolina? iii. ®Address the general education, health, or welfare ofNorth Carolina citizens? iv. [] Involve research with an htstitute or Center? 16. Location of Sponsored Activities (Please check all that apply): a. ®Sponsored Activity occurs in North Carolina: Ctty: County: Chanel Hi1UCarrbo~ O~apge b. [~ Sponsored Activity occurs outside of North CaroLna Two letter state _s_~ but within the United States: abbreviation (s): c. ^Sponsored Acfivity occurs outside of the I7nited States: Name of eanntty: d. [] Sponsored Activity occurs on campus: ~- If Sponsored Activity does not occur on campus, check one of the following: i. ®Sponsored Activities occurs within a 10-mile radius of campus. ii. [] Sponsored Activity occurs outside a 10-mile radius of campus. 17. Does this II'F require attachments? (Please check all that a ! No 17. rSignatureJl,ocatlon Addeadnm ^ Reguest for Fending [] YRB/IACUC ^ Suhconteactor As the PI, I understand that I am ultimately responsible for the study and its seiendfie, adminishative, fiscal and ethical performance, subject to University review and oversight, and in accordance with all relevant state and federal regulations, University policies and contractual obligations. I certify that all information on the form and the application is both accurate and complete. Sign: Date: Principal Investigator. ~ Madelejtte Grumet ~)~ ,,._,/. B . `_ ~ /r7~.. ___- /~. ~ c-~., ~,i~ I have reviewed this application and agree that the PI is appropriately qualified for performance of this project; it1Sa it is an appropriate activity within the Department/Center/Institute; and that the Department/Center/Institute has agreed to provide arty Deparmtent/Center/Institute resources identified in this application. c:.,... T_a Department Dttector: __ ~ - wya. ~ ~~~~_ L[LLG. Director of ~`~"~~"-'~'°~ `~ Institute/Center: ___ ~~_ Dean of School: Thomas lames ~ ~ ~~ r5~ i7~a Chancellor or Deli ee: Tony G, Waldrop, PhD ~ ._.____._.,.~.~, b j ~mce oL ~ponsorea Research !PF v 1,4 /) 2 _