Submit Letter of Intent for Head and Neck SPORE Pilot Funding

"*" indicates required fields

Deadline: within 2 weeks of pilot application deadline

Please submit your LOI within 2 weeks of the full application deadline. This helps us select the most appropriate reviewers for your application.

Select Pilot Program*

The Career Enhancement Program is directed toward early stage investigators (Assistant Professors only). The Developmental Research Program is open to established investigators pursuing Head & Neck translational research. If you are unsure, we can help you select the program best suited to your research.

Name*

First Last Degree(s)

NetID

Please provide your NetID (if applicable).

Email*

Anticipated Title of Application*

This can be modified in your final application.

Key Personnel

List key personnel you anticipate to be involved in this pilot project. CEP applicants are required to list at least one mentor. Click the "+" button to add more lines.

First Name

Last Name

Department

Role (Co-I, mentor, etc.)

Other potential conflicts of interest

Please list others you would like to remove from the reviewer list due to potential conflict of interest.

First Name

Last Name

Reason

Brief description of your project (2-3 sentences)*

Human Subjects Research?*

Will human biospecimens or clinical data (PHI) be involved in this research? Additional forms may be required in the application.

Yes

Yes, but no PHI involved

Unsure

SPORE Resources*

Please note any associated HN SPORE Resources you have contacted (encouraged).

Admin Core

Path Core

Biostats Core

Other

I would like more information