Form I
Checklist for Proposers

This checklist should be annotated to indicate that the stated items have been included in the proposal package.

Principal Investigator/Team Coordinator:       

    	Form A: IAO Proposal Application

	Form B: Proposal Executive Summary

	Form C: Project Signature Page

	Project Description

	Management Approach

	Letter of Assurance of Foreign Support (if applicable)

  	Form D: Biographical Sketch

	Form E: Other Support

	Supporting Budgetary Information

	Form F: Detailed Budget 12 Month (1st year of support)

	Form G: Summary Budget Projection

 	Form H: Summary Budget Form

	Facilities and Equipment Description

	Any other information

	Appendices, if any

	25 copies of all material listed above

Only one copy of the following needs to be submitted:

	3.5 inch computer diskette

	Form I: This checklist indicates all applicable items have been enclosed. 

FORM A
PROPOSAL APPLICATION	LEAVE BLANK	
IN RESPONSE TO THE INTERNATIONAL ANNOUNCEMENT OF OPPORTUNITY 	NUMBER	
FOR MICROGRAVITY RESEARCH	REVIEW GROUP	
PLEASE FOLLOW INSTRUCTIONS CAREFULLY	DATE RECEIVED	
1.	COMPLETE TITLE OF PROJECT
     	
2.    PRINCIPAL INVESTIGATOR/TEAM COORDINATOR (First, middle, and last name; position)
     	
3.   COMPLETE MAILING ADDRESS
      Internal Mail Code or Location
Office or Organization Division
Agency/Center, Company, or Institution
Street or P.O. Box
City, State  Zip Code
   COUNTRY	     	
4.  TELEPHONE NUMBER
(COUNTRYarea code, number)

FAX NUMBER

E-MAIL ADDRESS	     

             

     	
5.  TEAM MEMBERS/ CO-INVESTIGATORS (First, middle, and last name)

     

	6. INSTITUTION

     	

FORM B

PROPOSAL EXECUTIVE SUMMARY

Principal Investigator/	
Team Coordinator:		     
Co-Investigators/
Team Members:		     
     
     
	Proposal Title:		     

Executive Summary
Prepare a brief description of the proposal stating the objectives and specific aims of the proposed work.  Describe the research design and methods for achieving these objectives and aims.  This summary is meant to serve as a description of the proposed work independent of the proposal.  Limit the summary to two pages or less. 

     	

Form C			PROJECT SIGNATURE PAGE

Complete Title of Project: ………………………………………………………………………………

The signatories agree to accept responsibility for the scientific conduct of the project, within the roles and contributions described in this proposal.

Principal Investigator / Team coordinator: …………………….

Signature:…………………………                            Date…………………

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………                  

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………

Co-Investigator(s) / Team member(s): ……………………………..

Signature:…………………………                            Date…………………

FORM D
BIOGRAPHICAL SKETCH
Provide the following information for the key personnel.
Photocopy this page or follow this format for each person.	

NAME  
     
	POSITION TITLE
     
	
EDUCATION/TRAINING  
INSTITUTION(S) AND LOCATION	DEGREE(S)
(if applicable)	YEAR(S)	FIELD(S) OF STUDY	

     
	
     	
     	
     	
RESEARCH AND PROFESSIONAL EXPERIENCE:   Concluding with present position, list, in chronological order, previous employment, experience, and honors.  Include present membership on any Federal Government public advisory committee.  List, in chronological order, the titles, all authors, and complete references to all publications during the past three years and to representative earlier publications pertinent to this application.  If the list of publications in the last three years exceeds two pages, select the most pertinent publications.  DO NOT EXCEED TWO PAGES.

     

FORM E

OTHER SUPPORT
On a separate page, please provide information regarding specific sources of other support for the principal investigator and each co-investigator (not consultants).  The information should be provided separately for each individual in the format shown below.  Please list all active support for an individual before listing pending support.  Include the label “Form E” and the principal investigator’s name at the top of each page and number pages consecutively.	

NAME OF INDIVIDUAL
ACTIVE/PENDING	
   Project Number (Principal Investigator)	Dates of Approved/Proposed Project	Percent Effort	
   Source	Annual Costs	
   Title of Project (or Subproject)
	
   One sentence  description of project goals. (The major goals of this project are…)	
Brief description of potential scientific or commitment overlap with respect to this individual between this application and projects described above(summarized for each individual).	

FORM F
PRINCIPAL INVESTIGATOR/TEAM COORDINATOR:       

DETAILED BUDGET FOR 12-MONTH BUDGET PERIOD
DIRECT COSTS ONLY	FROM	THROUGH	
Duplicate this form for each year of grant support requested		
PERSONNEL    (Applicant Organization Only)	FUNDING AMOUNT REQUESTED	
NAME	ROLE IN PROJECT	EFFORT ON PROJECT	SALARY	FRINGE BENEFITS	TOTALS	
     	Principal Investigator/Team Coordinator	     	     	     	     	
     	     	     	     	     	     	
     	     	     	     	     	     	
     	     	     	     	     	     	
     	     	     	     	     	     	
	SUBTOTALS	     	     	     	     	
SUBCONTRACTS	     	
CONSULTANT COSTS	     	
EQUIPMENT (Itemize, use additional sheet if needed)	     	
SUPPLIES (Itemize by category, use additional sheet if needed)	     	
TRAVEL	DOMESTIC	     	
	NON-DOMESTIC	     	
OTHER EXPENSES (Itemize by category, use additional sheet if needed)	     	
TOTAL DIRECT COSTS FOR FIRST 12-MONTH BUDGET PERIOD
	     	
INDIRECT COSTS FOR FIRST 12-MONTH BUDGET PERIOD	     	
TOTAL COST FOR FIRST 12-MONTH BUDGET PERIOD
	     	

FORM G

PRINCIPAL INVESTIGATOR/PROGRAM DIRECTOR:       

BUDGET FOR ENTIRE PROJECT PERIOD DIRECT COSTS ONLY	
BUDGET CATEGORY TOTALS	1st BUDGET PERIOD	ADDITIONAL YEARS OF SUPPORT REQUESTED	
		2nd 	3rd 	
PERSONNEL (Salary and 
Fringe Benefits)
(Applicant organization only)	     	     	     	
SUBCONTRACTS	     	     	     	
CONSULTANT COSTS	     	     	     	
EQUIPMENT	     	     	     	
SUPPLIES	     	     	     	
TRAVEL	DOMESTIC	     	     	     	
	NON-DOMESTIC	     	     	     	
OTHER EXPENSES	     	     	     	
TOTAL DIRECT COSTS FOR EACH PERIOD	     	     	     	
TOTAL INDIRECT COSTS FOR EACH PERIOD	     	     	     	
TOTAL DIRECT + INDIRECT COSTS FOR EACH PERIOD	     	     	     	

TOTAL DIRECT + INDIRECT COSTS FOR ENTIRE PROJECT	     	

JUSTIFICATION FOR UNUSUAL EXPENSES (Detail Justification in Cost Section of Proposal)