GTAC-CDI Project Approval Form

Please complete and submit this form to Brittany Watz Klauser ([email protected]) for CDI funding approval.
GTAC-CDI Project Approval Form
Please fill out completely.
Date
Submitter's Name
E-Mail
Phone #
Lab/PI
ICTS member? (Yes/No)
CDI Grant ID #
Dept. # (4 digit dept billing number)
Dept. Billing Contact Name
Billing Contact E-Mail
Billing Contact Phone #
SCC member? (Yes/No)
GTAC Services
All GTAC services are eligible for the CDI subsidy.
# of Services
Billing Rate
Total Costs from GTAC*
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
* Costs must be obtained from GTAC ([email protected] or [email protected])
$ 0.00
In the space below, please provide a brief description of how the GTAC services requested will contribute to the achievement of the specific aims
for the CDI grant referenced above.
Instructions:
1. Contact GTAC ([email protected]) for project costs, as well as any additional questions regarding your study.
2. TWO WEEKS prior to submitting samples to GTAC for your study, fill out this form, including the project costs, and
send to Brittany Watz Klauser ([email protected]) for CDI approval.
3. Once approved, submit a copy of the form, with Approval ID #, to GTAC when samples are delivered. Please be sure to fill
out the GTAC samples submission form and indicate the CDI Project Approval ID # on that form as well. DO NOT submit
samples to GTAC until the project has been approved by the CDI.
CDI Use Only:
CDI Project Approval ID #
CDI Subsidy Account #
CDI Subsidy %
Notes:
3176-80915
50%

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