Internal application/proposal/nomination cover sheet this cover sheet is required

JOHNS HOPKINS UNIVERSITY - Limited Submission Programs

INTERNAL APPLICATION/PROPOSAL/NOMINATION COVER SHEET
This cover sheet is required for submitting internal applications, proposals, and/or nominations in response to program announcements, solicitations, or requests for nominations involving funding opportunities which require an internal peer review and selection. Submit this cover sheet and all required materials as one PDF via e-mail to the JHU Research Administration at [e-mail]. If you have any questions, please call 410-516-5917. If your application/nomination is selected during the internal review process, please submit all required materials to your department’s designated representative in your divisional office of Research Administration (ORA).

Name of Applicant/Principal Investigator/Nominee: ____________________________________________________________

Position Title: _____________________________ Appointment Date: ________________ Highest Degree: _______________

(Associate, Assistant Professor) (Month, Day, Year) (PhD, MD etc.)

Office Telephone: ___________________________ Cell/I Phone: _____________________ e-mail:______________________

JHU School/Division: ________________________________ Department: _________________________________

Name of Department Contact: _________________________ Telephone: _____________ e-mail: ______________

Sponsor/Foundation: The David and Lucile Packard Foundation

Program Title: Packard Fellowships in Science and Engineering for 2015

Required Internal submission date (to [e-mail]): February 11, 2015

Nomination deadline date to Sponsor/Foundation: March 16, 2015

Selected application/proposal/nomination due at divisional research administration office: April 13, 2015

Proposal deadline date to Sponsor/Foundation: April 20, 2015

Please provide answers to the questions listed below:
1. Have you submitted a project summary for this program (if it was announced) in previous years? _________________________

If yes, did you receive funding for that project from this sponsor? __________________________________________________

2. Is the attached project summary a request for renewal for an awarded project? ________________________________________
3. Please provide any additional information you believe would be helpful for the internal review on a separate page.
Along with this signed cover sheet, provide the items below:
 Candidate’s CV including current external research support and publications
 Description of candidate’s proposed research (a maximum of two pages of text which must NOT exceed 1,400 words in

12 point-font with one-inch margins) – should include aims, methods, and significance of proposed research. If there are

relevant figures, images, or references, please include these separately on a third page.
 Four Letters of Recommendation (one from the Department Chair and three references should be from outside of JHU –

At least one recommendation should be from a person who has had no supervisory or collaborative contact with the applicant.)

Letters should not exceed two pages, and should be prepared in 12-point font with 1-inch margins (see Packard 2015

Guidelines).

IMPORTANT - Please complete the requested contact information listed below:

Designated Representative in your Divisional ORA: _____________________________________ e-mail: ____________________

Department Chair: ________________________________________________________________ e-mail: ____________________

Department Administrator: _________________________________________________________ e-mail: ____________________

Campus Address: ____________________________________________________________________________________________

_______________________________________________________________________________ Date: _____________________

Signature of Applicant/Principal Investigator

________________________________________________________________________________ Date: ____________________

Signature of Department Chair

Please note: Any change in the proposed applicant/principal investigator after the submission of this form must be authorized in writing by the department chair and approved by the internal review committee before the final submission to the program sponsor. A formal request with justification should be sent to [e-mail] as soon as possible.

form last updated 8/4/2014