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Irving Institute/Clinical Trials Office 2012 Pilot Study Award ApplicationDETAILED BUDGET JUSTIFICATION: (use only space provided – minimum 11 point)Page 4 of 5
Irving Institute/Clinical Trials Office 2012 Pilot Study Award ApplicationSIGNATURES OF APPROVALA. I certify that the information presented in this proposal is, to the best of my knowledge, complete,accurate, and developed according to practices commonly accepted within the scientific community._____________________________________________________________________________Signature of Principal InvestigatorDateB. I have reviewed this application and agree to provide matching funds. Furthermore, I hereby takeresponsibility for ensuring that the necessary space, personnel, and facilities which are mentioned inthe application pertaining to my Department will be available for this project should it be funded. Irecommend that this application be submitted._____________________________________________________________________________Signature of Department ChairmanDateREMINDERSPLEASE REVIEW APPLICATION WITH DEPARTMENT CHAIR AND OBTAIN LETTER OF APPROVAL.Page 5 of 5
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