University of the PACIFIC

1. Name of funding agency:

10. List anticipated new personnel, facilities, and equipment required for the grant's successful implementation:

Personnel:

Facilities:

Equipment:

2. Name(s), e-mail(s) and phone number(s) of person(s) submitting this form:

3. Name(s) of person(s) writing the grant proposal:

11. Is there a requirement to sustain the program after the grant ends? If yes, describe the requirement and the institutional resources needed to sustain the program. Provide cost estimates of any required financial match or in-kind.

4. Has a director or principal investigator been identified for this grant? If yes, list their name here:

5. Grant application due date:

12. Will this project involve:

Human Subjects

Animals

Radiation

Hazardous Materials

6. URL for RFP:

7. Estimated Amount of funding sought:

8. Will matching funds be required?
YES NO

If yes: estimated amount:
$

Identify source(s)/index(es)

9. Proposed Project Title: