Project Proposal Form

NOTE: Responses Limited to Space Available
Required fields are marked with an asterisk (*)

Project Title*:

First Name*:

Middle Initial:

Last Name*:

Title:

E-mail*:

Organizational and cohort affiliation:

Plan for funding*: (Maximum lines: 7)

Background and significance*: (Maximum lines: 59)

Overall goal*: (Maximum lines: 6)

Specific aims: (Maximum lines: 12)

Design and analysis plan: (Maximum lines: 7)

Why a cohort consortium approach is necessary: (Maximum lines: 7)

Minimum number of cases per cohort:

Required outcome data: (Maximum lines: 7)

Required exposure data: (Maximum lines: 9)

Required covariate data: (Maximum lines: 9)

If yes, specify type and volume needed:

DNA Type:        Volume:

Blood Type:      Volume:

Serum Type:     Volume:

Plasma Type:   Volume:

If yes, indicate if special processing (e.g., fasting sample) is required: