TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER u: MISCELLANEOUS PROGRAMS AND SERVICES
PART 950 MEN'S HEALTH CODE
SECTION 950.230 APPLICATION


 

Section 950.230  Application

 

a)         The Department shall provide a written application, instructions, and forms to potential or requesting applicants.  In addition to other items required in this Part, the Department shall request at least the following items in the application:

 

1)         The name, address, and telephone, facsimile, and teletypewriter numbers of the applicant and principal investigator.

 

2)         The name, address, and telephone, facsimile, and teletypewriter numbers of the entity through which the application is being submitted.

 

3)         The curriculum vitae of the principal investigator.

 

4)         The Social Security Number, Taxpayer Identification Number, or the Governmental Unit Code assigned by the State Comptroller.

 

5)         The signature of principal investigator or agency official authorized to certify the application.

 

6)         A statement of whether funds are being requested for a fellowship or a general award.

 

7)         A statement of the research question, hypothesis, intervention, or model program on which the research will be based.

 

8)         A detailed budget for the funding period, documenting sufficient resources to carry out the project.  The budget shall be by line item category and shall provide sufficient detail to justify the use of grant funds to support project activities.  The applicant shall indicate the total cost of conducting the project, the anticipated funding request, if applicable, for years 2 and 3 of the project, the source of other funds supporting the project, and the amount of support requested from the Department.

 

9)         A one-page non-technical abstract that describes the significance of the applicant's project concerning prostate cancer.

 

10)         For each objective proposed for the first year of the project, a sequential listing of activities to achieve the objective, the timeline for completing each activity, and the identification of the individual responsible for coordinating the implementation of each objective.

 

11)         An approximate timetable for completion of the entire project.

 

12)         A prioritized listing of measurable objectives for the funding period.

 

13)         The evaluation methods to be used to measure progress in achieving objectives and a plan for monitoring the overall project.

 

14)         A signed statement of assurances indicating compliance with applicable State and federal statute and regulations.

 

15)         A statement of approval by an institutional review board for research involving human subjects.

 

b)         If the funds are being requested to support a fellowship, then the following information shall be provided in addition to the information required in subsection (a):

 

1)         The name of the individual to be supported through the fellowship.

 

2)         The curriculum vitae of the individual.

 

3)         At least one letter of recommendation from the principal investigator or agency official authorized to certify the application.

 

c)         Continuation applications shall contain the information required under subsection (a) and shall include at least the following additional items:

 

1)         A progress report of the status of each project activity to date, under the evaluation methods and monitoring plan specified in Sections 950.240 and 950.260.

 

2)         The project objectives for the new grant year, along with activities and timelines for completion of each activity.

 

3)         The revisions in the evaluation methods or the monitoring plan, with the reasons for the revisions.

 

4)         A budget and expense listing for the previous grant.