<p> TWU RESEARCH AND SPONSORED PROGRAMS</p><p>SUMMER 2017 RESEARCH INITIATIVE REQUEST FORM</p><p>1. INVESTIGATORS</p><p>Provide the following information for the faculty member(s) that will be working on the proposal. </p><p>Name & Title: Department: Name & Title: Department: Name & Title: Department: Name & Title: Department: Name & Title: Department:</p><p>2. PROJECT</p><p>Title: Brief Description / Abstract:</p><p>3. OUTCOME (PROPOSAL)</p><p>Funding Agency: RFA# or Name of Program: Deadline: Notes: 4. SUPPORT REQUESTED</p><p>In the space below, indicate what type of financial support is needed. The primary purpose of the program is to provide some salary funds for faculty during the summer to provide time to develop a research proposal. It is estimated that a maximum request of 120 hours (approximately .25 FTE) for the summer might be needed. Funds may be also be used for other items such as, but not limited to, editorial support, grant-writing support, statistical support, graduate student assistance, etc.</p><p>Investigators:</p><p>Name: # of hours: Role: Name: # of hours: Role: Name: # of hours: Role: Name: # of hours: Role: Name: # of hours: Role:</p><p>Other (mark N/A to none that apply):</p><p>Undergraduate Student (# of hours): Graduate Student (# of hours): Editorial / Grant Writing Support (explain): Statistical Support (explain): Other (explain):</p><p>Provide any other justification for support requested:</p><p>5. SUPPORT STATEMENT FROM DEPARTMENT CHAIR OR DEAN</p><p>Specify how support from this program will be leveraged by additional support from the department and/or college to move the faculty and/or research team toward a successful research program.</p><p>6. VITAE</p><p>Attach a CV for each investigator listed in item #1 to the application. 7. APPROVALS</p><p>______Signature of Investigator(s) Signature of Investigator(s)</p><p>______Signature of Department Chair / Component Administrator</p><p>______Signature of Dean</p><p>Submit one copy of this form with the CVs to the Office of Research and Sponsored Programs by Friday, March 3, 2017. </p>