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BASICS Principal Investigator Name PI's Email Proposal Title Proposal Type - Select -NEWRENEWALCONTINUATIONREVISIONRESUBMISSION Activity Type - Select -Research: BASICResearch: APPLIEDResearch: DEVELOPMENTResearch: CLINICAL TRIALTraining/InstructionService/Other Sponsored ActivityFellowshipIGPA Deadline If not new, enter related Kuali Research proposal # If previously funded, enter KFS # Start Date End Date SPONSOR INFO Sponsor/Agency NAME Sponsor's URL Sponsor Contact NAME Sponsor Contact PHONE Sponsor Contact ADDRESS Country - None -AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSamoaSan MarinoSão Tomé & PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabwe Sponsor Contact EMAIL Multiple email addresses may be separated by commas. Emails are only sent to cc and bcc addresses if a To email address is provided. Is your sponsor the PRIME sponsor, the source of funds? - Select -YesNo If no, enter Prime Sponsor's (source of funds) name Catalog of Federal Domestic Assistance Number (CFDA): AFRI Priority Code (When submitting a USDA-NIFA AFRI proposal) SUBMISSION MECHANISM/PROCESS Via Electronic System - Name/URL: Via Email Address: Notes, Special Instructions BUDGETING Total Requested Amount IDC Rate and Type IDC Rate and Type - Select -55.0%% - On Campus Research56.00% - On Campus Instruction40.0% - On Campus Other Sponsored Activities26.00% - Off Campus Remote27.50% - Off Campus Adjaceent11.00% - Off Campus IPAOther… Enter other… % IDC Application Type - Select -Total Direct CostsModified Total Direct Costs (Apply ONLY when using full IDC rate only)Other (IDC not budgeted) Will you be including cost-share? (Must be required by sponsor) - Select -YesNo Cost-Share: Total UM Amount Cost-Share: Total Non-UM Amount Is this a pre-proposal submission? - Select -YesNo Is this a MPowering the State (MTS) proposal? - Select -YesNo Is part of this project to be subcontracted to another organization? - Select -YesNo If "Yes," please enter the subcontractor(s) name(s).? Is any of the UM portion of this project to take place off-campus for a minimum of three consecutive months? (NOT Subawards) - Select -YesNo If "Yes," please enter the location(s). (e.g. Wye Research Center, etc.) Is the off-campus location a UM Research Farm? - Select - YesNo Does this project require work at a UM Research Farm? - Select -YesNo Does this project require Field Work? Field work includes all off-campus/off-site research activities in settings not associated with a subawardee institution nor with a UM Research Farm and regardless of length of time of field work. It includes data/information/samples being collecting in any urban or remote setting, including vessels and aircraft. - Select -YesNo Are there additional resources (space, operating or equipment funds, utility service) required to conduct this project over and above those already budgeted for or approved by your department? - Select -YesNo If "Yes," please list resource(s) Will this project involve the construction or renovation of a Biosafety Level -2 (BSL-2) or BSL-3 laboratory? - Select -YesNo Will this project require the significant alteration of a chemical fume hood, laboratory local exhaust system, electrical, plumbing, or building structure? - Select -YesNo Does this proposal include administrative support costs such as administrative/clerical salary and/or office supplies/communication costs? If yes, proposal budget must include explicit justification of these costs in accordance with UMCP Policy VIII-10.40(A). - Select -YesNo Does the proposal include a tuition or fee waiver on academic year, winter term, or summer programs? If yes, documentation of approval from the Office of Provost, Dean for Undergraduate Studies, or Office of Summer & Winter Terms must be provided with the proposal. - Select -YesNo Does this project offer courses for credit? - Select -YesNo Have the courses for credit been approved by Academic Affairs? - Select -YesNo List the courses for credit Is there a real or potential conflict of interest in connection with this work or this sponsor (including consulting) involving a University of Maryland employee, as defined by the University of Maryland Policies and Procedures II-3.10(A) or II-3.10(B) (https://research.umd.edu/coi)? If yes, a disclosure form must be completed and submitted in accordance with these procedures. - Select -YesNo Does this proposal need a Blanket IP Waiver? - Select -YesNo CREDIT SPLIT PI Credit PI Name Project Credit % Tenure Home Dept. Name Tenure Home % Joint Appointment Dept. Name Joint Appoinment Dept. % % Add Additional Key Person (2)? - Select -YesNo Key Person 2 Role, Key Person 2 Co-PI Key Person Name, Key Person 2 Project Credit, Key Person 2 % Tenure Home Dept. Name, Key Person 2 Tenure Home %, Key Person 2 % Joint Appointment Dept. Name, Key Person 2 Joint Appointment Dept. %, Key Person 2 % Add Additional Key Person (3)? - None -YesNo Key Person 3 Role, Key Person 3 Co-PI Key Person Name, Key Person 3 Project Credit, Key Person 3 % Tenure Home Dept. Name, Key Person 3 Tenure Home %, Key Person 3 % Joint Appointment Dept. Name, Key Person 3 Joint Appointment Dept. %, Key Person 3 % Add Additional Key Person (4)? - None -YesNo Key Person 4 Role, Key Person 4 Co-PI Key Person Name, Key Person 4 Project Credit, Key Person 4 % Tenure Home Dept. Name, Key Person 4 Tenure Home %, Key Person 4 % Joint Appointment Dept. Name, Key Person 4 Joint Appointment Dept. %, Key Person 4 % Add Additional Key Person (5)? YesNo Key Person 5 Role, Key Person 5 Co-PI Key Person Name, Key Person 5 Project Credit, Key Person 5 % Tenure Home Dept. Name, Key Person 5 Tenure Home %, Key Person 5 % Joint Appointment Dept. Name, Key Person 5 Joint Appointment Dept. %, Key Person 5 % Add Additional Key Person (6)? - None -YesNo Key Person 6 Role, Key Person 6 Co-PI Key Person Name, Key Person 6 Project Credit, Key Person 6 % Tenure Home Dept. Name, Key Person 6 Tenure Home %, Key Person 6 % Joint Appointment Dept. Name, Key Person 6 Joint Appointment Dept. %, Key Person 6 % EXPORT CONTROL/DATA RESTRICTIONS Are any export controls, physical or IT security requirements, restrictions on publications, or use of foreign nationals indicated in the solicitation or in discussions with the sponsor? - Select -YesNo Are there technologies involved in this project which are likely to have a military application or other applications which could be considered to have national security implications? - Select -YesNo Will your project involve the shipment of equipment outside of the US? - Select -YesNo List the materials and destinations. Will your project require collaboration with any foreign entity? - Select -YesNo List any foreign entity or individual with whom UMD will collaborate in relation to this project. Provide Name, Email, Phone, Institution Name, City, Country Will this project involve any information which may not be released to the public without sponsor approval? This may include, but is not limited to, sensitive research results, data sets, proprietary information, trade secrets, publications, and export-controlled information. - Select -YesNo Will such information be subject to a nondisclosure agreement or any other agreement authorizing a sponsor or other party to withhold from publication information provided to UM? - Select -YesNo COMPLIANCE Will this research include using Human Subjects? Select "Yes" or "No"YesNo Title used on IRB Application: IRB Protocol Approval Number IRB Approval Date: IRB application has not yet been submitted, but will be upon award notification. Will this research include using Vertebrate Animals? Select "Yes" or "No"YesNo Title used on IACUC application: IACUC Protocol Approval Number: IACUC Approval Date: An IACUC application has not yet been submitted, but will be upon award notification. Will radioactive materials (H-3, C-14, P-32, gamma irradiator, etc.) be used in this research?* YesNo Will devices which produce ionizing radiation (x-ray units, electron microscopes, particle accelerators, etc.) be used in this project?* YesNo Will a source of Non-Ionizing Radiation (lasers, infra-red devices, ultraviolet devices, radio frequency devices, other electromagnetic devices, and/or microwave devices) be used in this project? - Select -YesNo Check any which apply.* Laser(s) Radio Frequency devices Infra-red devices (other than lasers) Other Electromagnetic devices Ultraviolet devices (other than lasers) Microwave devices Will this research use biological materials? recombinant or synthetic nucleic acids; human pathogens; biological toxins; human blood; unfixed human tissue; human cell culture; unfixed tissue from non-human primates.* YesNo Will this project require the use of one or more of the following select agent toxins: e.g. Abrin; Botulinum neurotoxins; Short, paralytic alpha conotoxins; Diacetoxyscirpenol (DAS); Ricin; Saxitoxin; Staphylococcal enterotoxins (Subtypes A, B, C, D, and E); T-2 toxin; Tetrodotoxin?* - Select -YesNo Will this research use highly toxic/reactive gases (e.g. arsine, hydrogen cyanide, cyanogens, silane, florine, etc.)?* YesNo Will this project require the use of chemicals? If this project includes the use of chemicals, a Chemical Hygiene Plan and training is required.* YesNo Will this project require the use of toxic or pyrophoric gases? Toxic gases have NFPA health hazard ratings of 3 or 4, or a rating of 2, if the gas lacks physiological warning properties. A pyrophoric gas is defined as having an autoignition temperature in air at or below 130F (54.4C) - None -YesNo Will this project require the application of registered pesticides by UMD personnel? - Select -YesNo Will this project require the use of controlled substances? - Select -YesNo Will this project require the use of explosive materials (as defined by the US Department of Alcohol, Tobacco & Firearms)? - Select -YesNo Will this project require the use of a respirator by research personnel due to an airborne hazard not managed by engineering controls (e.g., use of chemical fume hood)? - Select -YesNo Will this project require SCUBA diving?* - Select -YesNo Will this research require the use of boats?* - Select -YesNo Will a motorized boat be operated by UMD personnel/affiliates in relation to this project? *Call DESSR, x53960, for assistance. Will this project require the shipment or transfer of chemical, biological, or radioactive materials off-campus?* - Select -YesNo HIGHER EDUCATION RESEARCH AND DEVELOPMENT (HERD) SURVEY Select the HERD Code that provides the best fit for your research. (UME: Please select: D.01) D.01 Agricultural Sciences ‐ Life Sciences D.02 Biological and Biomedical Sciences ‐ Life Sciences D.03 Health Sciences ‐ Life Sciences D.04 Natural Resources and Conservation ‐ Life Sciences D.05 Other Life Sciences ‐ Life Sciences H.02 Economics - Social Sciences Strategic Initiatives Please indicate by percentage those strategic initiatives that your project helps fulfill. No decimals. Should sum to 100%. Full descriptions of Strategic Initiatives ESTABLISH A HEALTHY FOOD SYSTEM AND ENSURE GLOBAL FOOD AND NUTRITIONAL SECURITY ENSURE A CLEAN AND HEALTHY CHESAPEAKE BAY ADVANCE INNOVATIVE, PROFITABLE, AND SUSTAINABLE AGRICULTURAL PRODUCTION SYSTEMS IMPROVE HUMAN, ANIMAL, AND ENVIRONMENTAL HEALTH OPTIMIZE URBAN ENVIRONMENTS THROUGH DESIGN, GREEN TECHNOLOGY, AND COMMUNITY ENGAGEMENT
