Project Performance Site(s) Name and Location Proposal Information Program Announcement or Solicitation Number: Title: Category UCC is Grant Proposal Sole Awardee Contract/Subcontract Lead Institution Cooperative Agreement Subawardee (describe) Other (describe) Executive Order 12372 Review Is application subject to review by state executive order 12372 Process? _____Yes _____No Have you contacted the Trial de Planificacion? _____Yes _____No Proposal Information Project Type Grant proposal due date: Research ___ post-marked or ___ arrive Public Service Project Date: Fellowship Equipment Project End Date: Conference ___ Paper submission Electronic Submission: Clinical ___ Grants.gov ___ Fast Lane ___ Other: ____________________ please specify Construction Webpage: Other (Describe): Does this proposal involve: Consultants? please list: Personal Services Agreement? yes, If
Project Performance Site(s) Name and Location Proposal Information Program Announcement or Solicitation Number: Title: Category UCC is Grant Proposal Sole Awardee Contract/Subcontract Lead Institution Cooperative Agreement Subawardee (describe) Other (describe) Executive Order 12372 Review Is application subject to review by state executive order 12372 Process? _____Yes _____No Have you contacted the de Planificacion? _____Yes _____No Project Type Proposal Information Research Grant proposal due date: ___ post-marked or ___ arrive Project Date: Project End Date: Public Service Fellowship Equipment Conference ___ Paper submission Electronic Submission: ___ Grants.gov ___ Fast Lane ___ Other: ____________________ please specify Clinical Trial Construction Other (Describe): Webpage: If yes, please list: Does this proposal involve: Consultants? Personal Services Agreement?
Internal-Routing-Form-Rev.-Oct-2014.docx