BUP Research Grant Registration Form

Applications for research grants that are administratively, structurally, or otherwise supported by BUP require pre-review by BUP and CGH to ensure institutional support. Please complete this form IN FULL as early as possible in the application process. It is acceptable to provide approximate numbers pre-submission. CGH will follow up with you to finalize support for your submission.

Grant Title:
Grant Source (ex: NIH, CDC, Internal Award etc.)
Activity Code, if applicable (eg R01, U54, etc.):
PI of Grant:
Co-Investigator Names/Institutions(s)
Other Main Points of Contact
Offical Penn Grant Name
Fund Number
Submission Deadline: Submission Deadline: / MM / DD YYYY
Proposed Start Date: Proposed Start Date: / MM / DD YYYY
Proposed End Date: Proposed End Date: / MM / DD YYYY
Proposed Total Cost:
Proposed Direct Cost for Entire Grant:
Proposed BUP Indirect Cost:
Proposed Indirect Rate (%):
Departmental Business Admin/Contact: Departmental Business Admin/Contact: First Last
Which BUP Operations Team Members will be Offering Direct Support? Enter "0" if None.
Does This Grant Utilize BUP Office or Research Facilities Support?

Does This Grant Utilize BUP Office or Research Facilities Support? Yes No
If "Yes", Which?
Does This Grant Utilize The UB Lab Center?

Does This Grant Utilize The UB Lab Center? Yes No
Brief Description of Study and BUP Services Required:
Proposed Direct Cost SPECIFIC TO BUP:
Are there any Subcontracts on this grant? If so, please list their name, home institution, and indirect rate %
Please upload a copy of your BUP SPECIFIC budget
Budgets must be created using BUP's template, found here: https://www.med.upenn.edu/botswana/research.html?preview=true

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