/ Center for Clinical and Translational Science and Training
University of Cincinnati Academic Health Center
3333 Burnet Avenue
Loc. S, 2nd Floor, Suite 500, ML 11028
Cincinnati, OH 45229
Voice: 513.803.8575
Fax: 513.803.1039
Web: cctst.uc.edu

Application Instructions for

Retreats/Workshops/Symposia

DEADLINES

Retreat applications are accepted year-round.

For questions regarding these instructions, please contact

Jonathan Hoehn,CCTST Program Coordinator (, 513-803-8575)

  1. Background: The mission of the CCTST is to stimulate the development of pre-clinical and human clinical trials.
  1. Funding Program: Support is available for multidisciplinary retreats/workshops/symposia (at CCHMC, UC or off-campusin the Greater Cincinnati metropolitan area) that will further the mission of the CCTST. Ideally, these events will provide a rich forum for basic, translational, and clinical scientists to interact and develop new initiatives.
  1. Budget: Up to $3,000 per event is available from the CCTST. Funds are contingent upon matching funds derived from other resources (typically clinical or research division resources or grants). Awards are made on a continuing basis, so early application in the fiscal year is encouraged.PLEASE NOTE: Alcohol is not considered to be an allowable expense.
  1. Eligibility: Applications will be accepted from all 80% or greater FTE faculty members of Cincinnati Children’s Hospital Medical Center, the University of Cincinnati, and the Cincinnati VA Medical Center, including nursing, health outcomes and other health care faculty with advanced degrees (M.D., Ph.D., or equivalent). Clusters of investigators spanning disciplines and programs made up of basic and clinical faculty are strongly encouraged to apply.
  1. CCTST Membership: All applicants for Retreat/Workshop/Symposia grant consideration must be CCTST Members. The CCTST Academic Membership is free and open to AHC faculty conducting or participating in clinical or translational research. For more information about CCTST membership and our online membership registration form go to
  1. Required format:Applications must be submitted electronically at least 60 days prior to the proposed event. Send a PDF file of the proposal . Proposals must be submitted in single spaced text, one-half inch margins, and no smaller than an 11-point Arial or Helvetica font is preferred. The primary applicant’s name must appear in the upper right hand corner of each page. Applications for retreats are strongly encouraged to be 1-2 pages in length, with a maximum of 3 pages (including figures but excluding references).
  1. Composition of proposal: Applications for support of a retreat should include:
  1. Table of Contents
  2. Face page
  3. Budget (PHS 398 form provided, located at
  4. Purpose of retreat
  5. Anticipated attendees (categories of people, not specific people)
  6. Format of meeting
  7. Proposed main speakers (including those external to institution)
  8. Location
  9. Duration and timing of proposed retreat
  10. Source of matching funds
  11. Letter documenting source of matching funds

rev 12-13-2016

Center for Clinical and Translational Science and Training
Grant Application
1.TITLE OF PROJECT (Do not exceed 56 characters, including spaces and punctuation.)
1a.Type of application: Research proposal TR Faculty Development Award Retreat proposal Core proposal
2. PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR / New Investigator No Yes
2a.NAME (Last, first, middle) / 2b.DEGREE(S)
2c.POSITION TITLE / 2d.MAILING ADDRESS (Street, city, state, zip code)
2e.DIVISION
2f.DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT
2g.TELEPHONE AND FAX (Area code, number and extension) / E-MAIL ADDRESS:
TEL: / FAX:
3. CO-INVESTIGATOR / New Investigator No Yes
3a.NAME (Last, first, middle) / 3b.DEGREE(S)
3c.POSITION TITLE / 3d.MAILING ADDRESS (Street, city, state, zip code)
3e.DIVISION
3f.DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT
3g.TELEPHONE AND FAX (Area code, number and extension) / E-MAIL ADDRESS:
TEL: / FAX:
4.Human Subjects Research
No Yes / 4a.Research Exempt
No Yes
If “Yes,” Exemption No. / 4b.Human Subjects Assurance No.
FWA00002988
4c.NIH-Defined Phase I Clinical Trial
No Yes / 5.Human Subjects Protection Certification: No Yes
5a.Certification Date:
6.Vertebrate Animals
No Yes
6a.If “Yes,” IACUC Approval Date
6b.Animal Welfare Assurance No. / 7.IBC Protocol
No Yes
7a.If “Yes,” Approval Date:
7b.Approval Number: / 8.Radiation
No Yes
8a.If “Yes,” Approval Date
9.DATES OF PROPOSED PERIOD OF
SUPPORT (month, day, year—MM/DD/YY) /
  1. COSTS REQUESTED
Direct Costs ($)
From / Through
12.The undersigned reviewed this application for a CCTSTresearch award and are familiar with the policies, terms, and conditions of CCTSTconcerning research support and accept the obligation to comply with all such policies, terms, and conditions.
Primary Applicant: / Division Chair of Primary Applicant:
Signature of Primary Applicant / Date: / Signature of Division Chair of Primary Applicant / Date:
Affiliate applicant: / Division Chair of Affiliate Applicant:
Signature of Affiliate Applicant / Date: / Division Chair of Affiliate Applicant: / Date:
Date Application Received by TRI: / Received By:
Principal Investigator/Program Director (Last, First, Middle):

DETAILED BUDGET FOR BUDGET PERIOD

DIRECT COSTS ONLY

/ FROM / THROUGH
PERSONNEL (Applicant organization only) / % / DOLLAR AMOUNT REQUESTED (omit cents)
NAME / ROLE ON
PROJECT / TYPE
APPT.
(months) / EFFORT
ON
PROJ. / INST.
BASE
SALARY / SALARY
REQUESTED / FRINGE
BENEFITS / TOTAL
Principal
Investigator
SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
PATIENT CARE COSTS / INPATIENT
OUTPATIENT
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD / $
CONSORTIUM/CONTRACTUAL COSTS / DIRECT COSTS
FACILITIES AND ADMINISTRATIVE COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD (Item 10, Face Page) / $

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