Name of main funding organisation: Select the category of the main study type: If selected DH/NIHR, or please define: Have you selected of the CRF” in the set-up costs “Use section of the commercial study costing template? Have you applied for NIHR portfolio adoption?: If yes, date applied: Number (if known/assigned): Are any research fellowships, Masters or PhD students attached to or supported by the study? NOTE: If yes, University of Leeds honorary contracts and GCP training are required prior to commencement of the study. Grant Administrating Organisation (if applicable, please state for academic studies) Which body will provide the research grant? organisation will administer the research grant? Sponsor Which organisation will be acting as the research governance sponsor? Has research governance sponsorship been confirmed? Account Holder The account for the study will be held at: If Other, please give details: CSU Signature CI/PI Name (print): Date: CI/PI Signature: Outcome of review: Agreed Provisional Rejected
Name of main funding organisation: Select the category of the main study type: If selected DH/NIHR, or please define: Have you selected “Use of the CRF” in the set-up costs section of the commercial study costing template? Have you applied for NIHR portfolio adoption?: If yes, date applied: Number (if known/assigned): Are any research fellowships, Masters or PhD students attached to or supported by the study? NOTE: If yes, University of Leeds honorary contracts and GCP training are required prior to commencement of the study. Grant Administrating Organisation (if applicable, please state for academic studies) Which body will provide the research grant? organisation will administer the research grant? Sponsor Which organisation will be acting as the research governance sponsor? Has research governance sponsorship been confirmed? Account Holder The account for the study will be held at: If Other, please give details: CSU Signature CI/PI Name (print): Date: CI/PI Signature: Outcome of review: Agreed Provisional Rejected
Capability-Application-Form-v1.0-07.11.2017.docx