Letter of Intent to submit a CFAR Developmental Proposal

Applicant/Principal Investigator:

First Name: *

Last Name: *

Degree *

Institution *

Department *

Email address *

Academic Appointment *

Assistant Professor

Associate Professor

Professor

Other Other

Cycle *

Spring

Fall

Year *

Application Type *

New

Resubmission

Type of proposal * 🛈

Initial HIV/AIDS

Pilot

Collaborative

Community Engaged Research

Collaborator (multiple-PI) name *

Collaborator (multiple-PI) email *

Collaborator (multiple-PI) Insitution *

Collaborator's (MPI) Academic Appointment *

Assistant Professor

Associate Professor

Professor

Other Other

Proposed Project

Project Title *

Upload the project abstract (250 word limit)

Describe how this proposal relates to the NIH HIV Research Priorities * 🛈

NIH HIV/AIDS Research Priorities

Study Team

Primary Mentor Name *

Primary Mentor Institution *

Primary Mentor Email *

Please list all other proposed mentors and collaborators indicating their institution and area of expertise

	Mentor/Collaborator	Institution	Area of Expertise
1	Mentor/Collaborator	Institution	Area of Expertise
2	Mentor/Collaborator	Institution	Area of Expertise
3	Mentor/Collaborator	Institution	Area of Expertise
4	Mentor/Collaborator	Institution	Area of Expertise
5	Mentor/Collaborator	Institution	Area of Expertise
6	Mentor/Collaborator	Institution	Area of Expertise
7	Mentor/Collaborator	Institution	Area of Expertise

Endorsements

By signing you, as the applicant, attest that the proposed project is not funded from other sources and if accepted you will follow the proposal guidelines in submitting a full proposal for consideration (sign with mouse). *

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Date *