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UImewEsSBIEbt6FDCQSTRs7qJF2rYspSyKIIBJcEMChs8GroC37New6ItEMJbMNeTJGp4sCY9m5nRZ78hiv2rmdRxngFGHSwDSMe9Fqyee7f

External Funding Request Approval Form

Aloha faculty and staff,

You are required to recieve prior authorization before submitting ANY extramural funding request. Please provide the information requested in the External Funding Request Approval Form below and submit your request for approval.

Mahalo!

First Name

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Last Name

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Email Address

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Phone Number

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What School are you affiliated with?

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Natural Science and Mathematics

Nursing and Health Professions

Education and Behavioral Sciences

Humanities, Arts and Design

Business and Communication

Other

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Proposal Title:

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Provide a brief description of your project:

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What is the purpose of your project? Please check all that apply.

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Capital (construction or renovation)

Equipment

Research

Curriculum Development

Student Programs

Conference Support

Scholarships

Other

Describe the ʻOtherʻ purpose

* must provide value

When is the proposal due?

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M-D-Y

If awarded, what is the proposed project start date?

* must provide value

M-D-Y

If awarded, what is the proposed project end date?

* must provide value

M-D-Y

What is the total award amount sought?

Include total direct funds for all years of the project.

* must provide value

What, if any, is the indirect cost (IDC) rate associated with this proposal?

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Your IDC rate is different from the federally authorized rate of 45%. Have you received an IDC Waiver from the Provost?

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Yes

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Please attach a copy of your IDC Waiver approval email here

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Upload file

Please obtain Provost authorization by completing and submitting an IDC Waiver Request form. Click the "Save & Return Later" button at the bottom of this page to save your work. You may return to this page and complete this form once you have received an IDC Waiver confirmation.

The IDC Waiver Request form can be found at:

https://redcap.chaminade.edu/redcap/surveys/?s=KMKNTMA9DNPEWF4T

(if the link odes not work, cut and paste the URL above into your browser)

Are there co-PIs on this proposal?

* must provide value

Yes

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Is your Co-PI a Chaminade University faculty member or staff person or are they from a different institution?

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Yes

I have Co-PIs from Chaminade and different institution(s)

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Please provide the name(s) of your Chaminade University Co-PI(s)

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Please list the non-Chaminade affiliated Co-PI name(s), Position(s) and Affiliation(s) below.

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Do you have all appropriate agreements in place with your non-Chaminade affiliated Co-Investigator (i.e. Memorandum of Agreement (MOA), Material Transfer Agreement (MTA), Intellectual Property Agreement)?

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Yes

I donʻt know / not sure

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Please attach copies of your completed agreements here.

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Upload file

Please consult with your supervisor and/or Dean regarding what documents you may need before your proposal is submitted

Will this proposal include Sub-Awards?

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Yes

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What is the name of the institution/organization receiving the largest (or only) sub-award?

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Please provide the amount of the largest (or only) sub-award.

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Do you want to add a second sub-award in your proposal?

* must provide value

Yes

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What is the name of the institution/organization for sub-award 2

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What is the amount of sub-award 2?

* must provide value

Do you want to add a third sub-award in your proposal?

* must provide value

Yes

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What is the name of the institution/organization for sub-award 3

What is the amount of sub-award 3?

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Do you want to add any additional sub-awards in your proposal?

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Yes

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Please list any remaining sub-awards using the format: Institution, $ amount

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Funding Source Type:

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Federal

State

City/County

Business/Industry

Philanthropic

Other

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Please provide the name of the ʻBusiness/Industryʻ funding source.

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Please provide the name of the ʻPhilanthropicʻ funding source.

Please provide the name of the ʻOtherʻ funding source.

* must provide value

What Federal Agency will you be applying to?

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National Science Foundation (NSF)

Dept. of Defense

Dept. of Education

Dept. of Energy

Dept. of Agriculture

NOAA

Other

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Please provide the name of the ʻOtherʻ Federal agency

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What State Department or Agency will you be applying to?

* must provide value

Department of Agriculture

Department of Business, Economic Development, & Tourism (DBEDT)

Department of Education

Department of Hawaiian Homelands

Department of Health

Department of Human Resources Development

Department of Human Services

Department of Labor & Industrial Relations

Department of Land & Natural Resources

Department of Transportation

Office of Hawaiian Affairs

Hawai'i Tourism Authority

Hawai'i Visitors Bureau

Other

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Please provide the name of the ʻOtherʻ state department or agency.

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What County will you be applying to?

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Honolulu

Maui

Kaua'i

Hawai'i Island

Other

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Please provide the city, state and county of your funding source.

* must provide value

Is there a Hawaiian cultural component to the Project?

* must provide value

Yes

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Marianist values included in your proposal:

* must provide value

Educate for formation in faith.

Provide an integral, quality education.

Educate in the family spirit.

Educate for service, justice, peace and the integrity of creation.

Educate for adaptation and change.

None

United Nations CIFAL SDGs are addressed in your proposal:

* must provide value

No poverty

Zero hunger

Good health and well-being

Quality education

Gender equality

Clean water and sanitation

Affordable and clean energy

Decent work and economic growth

innovation and infrastructure

Reduced inequalities

Sustainable cities and communities

Responsible consumption and production

Climate action

Life below water

Life on land

justice and strong institutions

Partnerships for the goals

None

Does the proposed Project require the allocation of any new space?

* must provide value

Yes

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Please describe the new space requirements.

* must provide value

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Will you be acquiring new equipment with this award?

Equipment is defined as an item of non-expendable, tangible personal property, having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the recipient organization for financial statement purposes, or $5,000.

* must provide value

Yes

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Please describe the equipment you expect to purchase with this award.

* must provide value

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What is the expected cost of the equipment you intend to purchase?

* must provide value

Do you currently have space to place and/or store this equipment?

Yes

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Describe your plan for placing and/or storing this equipment.

* must provide value

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Will the deployment of this equipment require any modifications or remodeling of existing space?

* must provide value

Yes

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Please describe what modifications or remodeling will be required to deploy this equipment, including estimated costs.

* must provide value

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Does the Project propose funding for faculty summer salaries or staff extra service pay?

* must provide value

Yes

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Describe your proposed funding for faculty summer salaries or staff extra service pay.

* must provide value

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Does the Project require any funded or unfunded release time from teaching or administrative duties for anyone involved?

* must provide value

Yes

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Describe in detail your proposed faculty/staff release time from teaching or administrative duties.

* must provide value

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Does the Project involve research on vertebrate animals?

* must provide value

Yes

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Have you received approval for this work from the Institutional Animal Care and Use Committee (IACUC)?

* must provide value

Yes

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Please attach IACUC approval documentation here.

* must provide value

Upload file

You will need to obtain IACUC approval before the university can accept this award.

Does the Project involve research on human subjects?

* must provide value

Yes

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Have you received approval from the Institutional Review Board (IRB)?

* must provide value

Yes

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Please attach IRB approval documentation here.

* must provide value

Upload file

You will need to obtain IBC approval for this work before the university can accept this award.

Signature: [Requestor]

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Add signature

Signature Date

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M-D-Y

Attachment 1. FEDERAL CONFLICT OF INTEREST DECLARATION (updated November 2019)
(fill this section only for Federal grants in which the requestor is the Principal Investigator). The disclosures relate to the topic of the specific grant being submitted.

NSF and Other Non-Public Health Services Federal Financial Disclosure
Applicants to the National Science Foundation must disclose project-related financial interests for themselves and all other project investigators at the proposal submission stage.
The PI is responsible for answering "Yes" or "No" to the following question on behalf of all Chaminade personnel (including the PI) who meet the definition of investigator and are involved in the proposed project.
Do you, your spouse, your registered domestic partner, and/or your dependent child(ren) have any of the following interests that (i) would reasonably appear to be affected by the research for which funding is sought, or (ii) are in the sponsor of the research, or (iii) are in entities whose financial interests would reasonably be affected by the research?

* must provide value

Yes

Not a Federal Grant

Receipt of income or payment for services over the past 12 months from any single business entity exceeding $10,000; Any equity interest exceeding $10,000; Any intellectual property interest assigned or to be assigned.
Did any Chaminade investigator involved in this proposed project (including the PI) answer "Yes" to the above question? If yes, please list the individuals who meet the definition of investigator on this project who answered "Yes." Click here to enter text.

PHS Financial Disclosure (e.g., NIH proposals)
The Public Health Service (PHS) requires disclosure of significant financial interests by all investigators who participate in PHS-funded research either directly or by subaward
The PI is responsible for answering "Yes" or "No" to the following question on behalf of all Chaminade personnel (including the PI) who meet the definition of investigator and are involved in the proposed project.
Do you, your spouse, your registered domestic partner and/or your dependent child(ren) have any of the following financial interests related to your institutional responsibilities? ☐ Yes ☐No
Receipt of income or other payment for services over the past 12 months from and/or equity interest(s) in a publicly traded entity totaling more than $5,000; Receipt of income or other payment for services over the past 12 months from a non-publicly traded entity totaling more than $5,000; Any equity interest(s) in a non-publicly traded entity; Receipt of payments for any intellectual property rights and interests totaling more than $5,000.

If yes, please list the individuals who meet the definition of investigator on this project who answered "Yes" please enter into text box.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.