Research Intake Form

Your name/PI:

Contact email:

Activity Type:

Project Title:

Enter TBD if unknown

Project Dates:

(Start Date/End Date)

Due Date:

Upload Funding Announcement/RFP

If there is no file to upload, add the link in the Funding Announcement Link field.

Funding Announcement Link:

Enter link

Other Project Personnel

ASU Co-PIs/Senior Personnel:

Subaward Institution PI and Co-PIs (including contact information):

External Collaborators:

Allocations table

Investigator Name:

Center (if applicable):

REC %

RID %

IIA %

Budget Request Section

Please use text box at the end of this form to include any additional information regarding budget requests not indicated in the form below.

Total Project Budget Target (USD):

Principal Investigator Effort

Name:

Effort per year in months (Summer or AY or calendar):

ex. 1 sum month YR 1&2, 3 AY months Yr 3

Personnel Name:

Project role:

Effort per year (in months):

Additional ASU personnel name(s):

Please indicate Co-PI or Senior Personnel or Other Personnel and Position)

Add # of Post Doc, Grad Students, or hourly students and duration (full year, AY, SU)

Enter the number involved with specifics:

ex. 2 Full Time GRAs AY 1 thru 3. 1 Hourly GSA Yr 1, summer, FT post doc annually

Annual Domestic Travel (USD):

ASU personnel only

Annual Foreign Travel (USD):

ASU personnel only

Please list any meetings/conferences/destinations - # of days/nights, how many travelers?

Annual Non-capital Equipment (USD):

ex. 6000 in year one ($1500 external hard drive x 2; $3k laptop for work offsite)

Annual Materials/Supplies (USD):

ex. 5000 in year one (printing, voice recorders, etc, with cost breakdown, $2k for reagents; $3k for masks)

Annual Consultants (USD):

ex. 2000 in year one for a TBD consultant ($50/hr for 40 hours of work)

Annual Publications (USD):

ex. 1500 for page charges (American Anthropologist)

Annual Other Costs (USD)

Type:

Cost:

Enter anything to discuss here:

F&A rate limitation, participant support, human subject pay, cost sharing, subaward specifics.

Compliance (Special Reviews)

Program Classification/Project Category

Project Identifier:

(award #, project title, etc.)

What specific action(s) is requested?

Please elaborate in specific detail.
Ex. No cost extension, allocation change, rebudget etc.

Relevant File Attachments:

One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Additional comments: