UCSB Computer Science Proposal Request Form
General Information
PI Name
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Prime Sponsor
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National Science Foundation (NSF)
Defense Advanced Research Projects Agency (DARPA)
Office of Naval Research (ONR)
Department of Energy (DOE)
Other
Prime Sponsor
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Solicitation #
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Opportunity #
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Program / Call #
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Sponsor Deadline
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Year
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AM/PM Option
Project Title
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Project Start Date
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Month
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Year
Date
Project End Date
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UCSB Computer Science Proposal Request Form
Other Questions
Do you need to submit earlier than the Sponsor deadline?
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Yes
No
Requested Early Deadline
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Month
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Day
Year
Date
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AM/PM Option
Justification for Early Deadline
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Are there any additional UCSB Co-PIs on this proposal?
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Yes
No
Additional Co-PI Names and Emails
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Will this project include one or more subawards or subcontracts?
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Yes
No
Other Information or Requests
Will UCSB be a subawardee on this proposal? / Are we submitting to an institution that will serve as a flowthrough sponsor?
Yes
No
Flowthrough Entity
*
PI Name
*
PI Email
example@example.com
Administrative Contact
Admin. Contact Email
example@example.com
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UCSB Computer Science Proposal Request Form
Subawards / Subcontracts
How many sub-recipients?
*
Sub-recipient Entity #1
*
PI Name
*
PI Email
example@example.com
Administrative Contact
Admin. Contact Email
example@example.com
Sub-recipient Entity #2
*
PI Name
*
PI Email
example@example.com
Administrative Contact
Admin. Contact Email
example@example.com
Sub-recipient Entity #3
*
PI Name
*
PI Email
example@example.com
Administrative Contact
Admin. Contact Email
example@example.com
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UCSB Computer Science Proposal Request Form
Assurances
Locations at which your research will be performed (eg Lab #s):
*
Does the proposed research involve any of the following:
Human Subjects Research
Protected Health (HIPAA) Information
Personal Identity Information (SSN or Driver’s License with First & Last Name)
Foreign Sponsor
Foreign Collaboration or Sub-recipient
International transfers/shipments of any technical information, equipment, items, or materials(e.g., sending project deliverables)
Collaboration with or travel to Cuba, Iran, Syria, North Korea, Ukraine (Crimean Region) by UCSB personnel
Will any of the H.S. research be performed at UCSB or by UCSB personnel?
Yes
No
Does this project involve multiple US institutions conducting non-exempt human subjects research at more than one domestic site?
Yes
No
Will any of the following be used for this project:
Chemicals (solids, liquids, or gases)
Radioactive materials
X-ray producing machines
Non-ionizing radiation (lasers, UV, microwave)
Biosafety Level 2, Level 3, or “Select” Biological agents
Recombinant DNA
Human/primate tissues or fluids
Animals or animal tissue/fluids
Research divers/dive equipment/small boats
Controlled Substances (DEA Schedule I-IV)
Has any personnel participating on this project (UCSB employee or student) purchased, plan to purchase, or use any telecommunications or video surveillance equipment or services produced by Huawei Technologies Company,ZTE Corporation, Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities)?
*
Yes
No
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