2.  Principal Investigator:  

Name_______________________________________ Degree(s)______________________

Social Security #______________________________ Date of Birth___________________

Position Title_____________________________________________

Mailing Address:
____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Telephone:  (_______)_________________ Fax:  (_______)__________________

Email Address:  ____________________________________________________________________________________________

3.  Performance Sites (Organizations and Addresses)

4.  Human Subjects:       ___   Yes       ___   No

5.  Vertebrate Animals:      ___   Yes       ___   No

6.  Principal Investigator Assurance:

The undersigned agrees to accept responsibility for the scientific, technical, and financial conduct of the research project, and for provision of required reports if a grant is awarded as a result of this application.

Number the remaining pages of the application starting with page 5. Do not exceed 5 pages for items 1-3. Organize items 1 - 3 to answer the following questions:

What do you intend to do?
Why is the work important?
What has already been done?
How are you going to do the work?

1. Background and Significance.
   State the nature of the craniofacial and/or cleft lip and palate problem to be investigated. Review the most significant and relevant previous work and describe the current status of research in this field. Document with references. Describe any preliminary work you have done that is relevant. Discuss the potential importance of the proposed work.
2. Specific Aims.
   Summarize the objectives of the proposed project. What is the specific research intended to accomplish? What, if any, hypotheses are to be tested?
3. Research Design and Methods.
   Describe the research design and the procedures to be used to accomplish the specific aims of the project. Include information regarding data collection, analysis, and interpretation procedures. If clinical studies are involved, give details of patient selection and patient care. Provide a tentative sequence or timetable for the investigation.
4. Human Subjects.
   If you indicated "Yes" for Item 4 on page 1, provide evidence of protocol approval by your Center's Institutional Review Board (IRB). If this approval is not received at the CPF National Office by April 1, the application cannot be considered.
5. Vertebrate Animals.
   If you indicated "Yes" for Item 5 on page 1, provide evidence of protocol approval by your Center's Institutional Animal Care and Use Committee (IACUC). If this approval is not received at CPF by April 1, the application cannot be considered.
6. Consultants/Collaborators.
   If the proposed project requires additional collaboration with other institutions or persons, describe the collaboration, and provide written evidence of the collaborating institutions and individuals willingness to participate.
7. Resources.
   Describe the facilities available for the project, including laboratories, clinical resources, office space, etc. List major items of equipment available for this work.
8. Professional Effort.
   State the level of commitment of the principal investigator to the proposed project in relation to total percentage of professional activity.
9. Budget.
   Provide a detailed line-item budget of supplies, equipment, patient costs, or other expenses to be incurred in the proposed project. The total budget should be no more than the maximum allocation for the grant to which you are applying (see below). Indicate and give assurance of the source of any additional funds required for the successful completion of the proposed project, including letters assuring support if other funds are not forthcoming. Refer to the Terms of the Grant for budget restrictions.