Today's Date:

Name/Principal Investigator (PI) (Grant Seeker):

Private Investigator's Title:

Co-Private Investigator's Name:

Co-Private Investigator's Title:

Department/Division:

Pellissippi State E-mail Address:

Phone:

How far along are you with your project idea?

Project idea needs further development - need discussion and literature search regarding potential projects and grant opportunities.

Project idea is formulated - Need help in identification of potential funding source(s).

Project idea is formulated - Have obtained support for project idea from Department Head.

Potential funding source is identified:

      Funding Source:

      Maximum grant amount available:

      Matching funds required:

      Application due date:

Other activities already completed:

Briefly describe the project you would like to have funded:

What are the needs/problems to be addressed and population(s) to be targeted?

Identify the two top project outcomes:

Briefly describe how the proposed project fits into the mission of your department and the college.

What is this project's priority:

Do you expect this to be a:

one-time project
multi-year project
an on-going project

Yes or No: I have discussed this proposal with my department Dean who encourages assistance with pursuing funding for this idea.

Please type in your name to submit form electronically.

Dean's Signature                                                                                             Date

Please print out the form by going to File > Print and obtain your Dean's signature and forward completed form with Dean's signature to Grant Development.

Thank you!