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Research Registration


  • 1. Principal Investigator (PI):  Last Name:

    First name:
    2. Department Department Chair:
    3. Office (Building / Room #): Lab Location (Building/Rm): 

    4. Phone Number:

    E-mail:

     

    5. Project Title:

    6. Committee Protocol Number(s):

    IACUC
     

    IBC       

      IRB      
    7. Grant Funding Agency:  

    8. Budget #:

    UMES Grant/Contract Account #:

        

     

    9. Protocol Approval Date:  

     

    10.  List all other faculty/staff/graduate/undergraduate personnel (including principal investigators) working on this project.  Check the box for "Safety Training" for those who have completed safety training.  

     

    Name

    Rank

     Safety Training

    Training Date(s)

     

     

     
     

     

     
     

     

     
     

     

     
     

     

     
     

     

     
     

       

     

    11.  The research project involves the following:

    Animals

    Biological Material:  including          

    Chemicals 

    Controlled Substances 

    Radioactive material Radiation-producing equipment 

    Other:  Please specify: 

    12.  Please list licenses and/or permits (e.g. import/export of selected agents, rare and endangered species) associated with this project.

     

    13.  Please provide a protocol-specific description of how hazardous procedures will be controlled to protect personnel (e.g. personal protective equipment, work practices, etc.)

     

    14.  Please describe post-exposure procedures that will be followed in the event of an accidental exposure.

     

    15.  Please provide a project description from the grant or contract (copy and paste). 

     

    16. Please provide a description of the project in layman's terms (do not cut and paste from grant application).  Limit 100 words.

     

     

    To Office of Sponsored Research & Programs