2010 VIU Institutional Signature Sheet for Research Funding

(For ALL external applications and VIU Research Awards Committee internal applications)

Information – The Basics

Applicant / RSAO PID
VIU Status / Are you regular faculty? Y N / Department/Faculty
Co-Applicant(s)
Application deadline / Funding Agency
Project Title
Does this project involve international activities or travel? Y N

Certificates

Does this proposal involve human participants? / YES / NO / Date of Approval:
Does this proposal involve animal subjects? / YES / NO / Date of Approval:
Does this proposal involve biohazards? / YES / NO / Date of Approval:
Does this proposal involve Controlled Goods? / YES / NO / Date of Approval:

VIU Commitments (Cash) -Indicate any institutional cash commitments and cost centre OR SOURCE

Details/Source / Year One / Year Two / YearThree / YearFour / Year Five / TOTAL
Cost Centre/Source
Cost Centre/Source

VIUIn Kind Commitments & Notes –(e.g. space, equipment, personnel, services, facilities, or other resources)

SIGNATURES FOR LEAD RESEARCHER TO OBTAIN
APPLICANT -By signing, I ______indicate my acceptance of responsibility for the project, as well as my agreement to comply with the terms and conditions of the funding agency and research-related policies and procedures of Vancouver Island University (VIU). DATE: ______
DEPARTMENT CHAIR - By signing, I ______acknowledge the availability of facilities and space in the department and the proposed time commitment by the applicant to the project.
DATE: ______
INSTITUTE/CENTRE DIRECTOR(If Applicable) - By signing, I ______confirm the applicant’s proposed use of Centre/Institute equipment, facilities, personnel and/or funds.
DATE: ______
DEAN - By signing, I ______confirm the eligibility and appointment of the applicant and signify awareness of faculty research activities and acceptance of resource commitments, including institutional commitment(s) listed above. DATE: ______
SIGNATURES FOR RESEARCH & SCHOLARLY ACTIVITY OFFICE TO ObTAIN
DIRECTOR, RESEARCH SERVICES - By signing, I ______, on behalf of the Vice-President Academic and Provost, agree to accept and administer the proposed research funds, if awarded.
DATE: ______
VICE-PRESIDENT ACADEMIC AND PROVOST - By signing, I ______, on behalf of Vancouver Island University, agree to administer any grant received according to the granting agency’s policies.
DATE: ______