JHU School of Nursing
Intent to Submit a Proposal

To be completed by the Principal Investigator (PI)

Over $500,000 direct cost annually requires prior approval from the Funding Agency

Note: Once the form is submitted, a copy of the completed form will be available for printing.

PI First Name:
PI Last Name:
PI Credentials:
Phone:
Fax:
Funding Agency:
Proposal Type (e.g. R01, R03):
Is this a new proposal or a resubmission?:	--Select One-- New Submission Resubmission

Due date for the proposal:

Project dates covered by proposal:

Title of project:  
Note: NIH guidelines are 56 characters or less

IMPORTANT NOTE: IF YOU DECIDE NOT TO SUBMIT OR MAKE SIGNIFICANT CHANGES TO THE INFORMATION ON THIS FORM (I.E. MECHANISM, FUNDING SOURCE, P.I. % OF EFFORT, ETC.), YOU MUST COMPLETE AN ADDENDUM TO THE "INTENT TO SUBMIT A PROPOSAL" FORM (Attachment A1).

NOTE: Your proposal will be reviewed during the standing Scientific Review Committee (SRC) meeting.  Additional SRC meetings will be scheduled as needed.

2. Do you need to consult with Center faculty regarding this proposal?  

NoYes (Center will schedule an appointment)

3. If you consulted with someone other than current CNR staff, please identify them below:
512 characters max

Personnel
1. PI % of Effort:
Will effort be fully compensated if award?  

NoYes

2. Do you anticipate any need to discuss a modification of SON roles or responsibilities?  

NoYes

3. Other SON Faculty, Senior Staff or Support Staff to be named on this proposal:
512 characters max

4. Do you anticipate any need to discuss a modification of their SON roles and responsibilities?  

NoYes

Budget
1. Will there be any matching or cost sharing?  

NoYes

2.  Does this involve a subcontract?  

NoYes

3.  Have you consulted with the business office regarding this proposal?  

NoYes

OPTIONAL: For proposals seeking external funding, you are encouraged to use an external reviewer to  either participate in the SRC meeting or review the proposal independently. The PI is responsible for  initial contact and confirming external reviewer participation prior to submitting this document to the Center. The Center will send a copy of the proposal and review form to the chosen external reviewer  reviewing independently.  As well, the Center will also arrange for compensation for external independent  reviews only (non-JHU faculty member).  Please list external reviewer(s) to be contacted (please list 3  possible choices).

	Name, Credentials and Institutional Affiliation	Area of Expertise	Adress, Phone #, Email
1st
	Attending SRC Meeting Reviewing Independently
2nd
	Attending SRC Meeting Reviewing Independently
3rd
	Attending SRC Meeting Reviewing Independently

Note: If you decide not to submit your proposal, please contact the CNR.