OHSU Notice of Intent Form for Proposal Submission to Collins Medical Trust

This form must be submitted during a posted Notice of Intent Window listed on the Collins Medical Trust O2 page. Questions? Contact the OHSU Foundation at ohsufr@ohsu.edu.

Applicant's First Name*

Applicant's Last Name*

Applicant's Suffixes / Credentials*

MD, PhD, etc.

Applicant's Email Address*

Applicant's OHSU Appointment/Job Title*

Applicants must be advanced stage postdoctoral fellows and assistant professors and eligible under OHSU's PI Eligibility Requirements.

Applicant's Primary Department*

Department Chair*

Department Administrator

Department Grant Coordinator

Department Finance Analyst

Submission Deadline*

Choose April 30, August 31 or December 31.

Project Title*

Projects should position applicants for their own NIH or other substantial funding.

Project Amount

Not to exceed $30,000.

Mentor(s)

Applicants must be clearly supported by their mentor(s).

Abstract or Specific Aims

Optional, used for background information only and may be shared with department chair.

Drag and drop files here or

Other Comments

OHSU/VA Joint Appointment

In order to manage the transfer and reporting of any funds awarded by the Collins Medical Trust in a timely manner, it is requested that PIs who hold joint appointments within OHSU and the VA submit proposals through the institution where the majority of any funds granted by the Trust will be held. By checking the box below, you agree that if awarded, more than half of your funds will be held at OHSU, regardless of a joint appointment or full appointment at OHSU. Please see the Collins Medical Trust FAQ page for more info.

OHSU / VA Joint Appointment Acknowledgement*

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