RFA 67-211 Cover Page.pdf

204 KB Posted

Attached to
Spinal Cord Injury Research Grant
Solicitation number
RFA 67-2011
Issued by
Dauphin County, Harveys Lake Borough, Pennsylvania

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This is a cover page for Request for Applications (RFA) 67-211 issued by the Commonwealth of Pennsylvania for a Spinal Cord Injury Research Grant. The grant opportunity is structured to support research initiatives that directly improve the health outcomes of Pennsylvanians living with spinal cord injuries, with all funded work to be conducted in compliance with Act 77 of 2001. The RFA establishes the framework for soliciting competitive applications from qualified researchers and institutions seeking to advance spinal cord injury research within the state.

The document serves as the formal introduction to the complete RFA package and establishes the administrative and programmatic parameters for the grant competition. As a cover page, it provides essential information regarding the application process, including the RFA number, title, and reference to the governing legislation. Specific details regarding application deadlines, funding amounts, eligible applicants, evaluation criteria, and other substantive requirements would be contained in the supplementary sections of the complete RFA package accompanying this cover page.

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Other files

File Type Posted
RFA 67-211 MOU Regarding Ethical Standards.pdf PDF
RFA 67-211 Letter of Intent Form.pdf PDF
RFA 67-211 Certifications for the Containment of Research.pdf PDF
RFA 67-211 Budget.xlsx XLSX spreadsheet
RFA67-211.pdf PDF
RFA 67-211 Worker Protection Certification Form.pdf PDF
RFA 67-211 Certifications for the Protection of Human Subjects.pdf PDF
RFA 67-211 Research Proposal and Letters of Support (III).pdf PDF

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RFA #67-211

Attachment I

COVER PAGE

Spinal Cord Injury Research Grant

Type of Grant: Health Research Non-Formula Grant

Applicant Name: _________________________________________________________________________ (Legal Name of Organization or Institution, exactly as registered with PA Dept. of State) Type of Legal Entity: ______________________________________________________________________ (Corporation, Partnership, Professional Corporation, Sole Proprietorship, etc.)

Grant Amount: $____________________ Grant Start Date: July 1, 2027

SAP Vendor #: ______________________ Grant End Date: June 30, 2031

Federal ID#: ________________________

Address*: ________________________________________________________________________________

City: _______________________ County: __________________ State: ________ Zip Code: ____________

(Complete billing address that corresponds to the organization or institution’s vendor number; this should be the same as the billing address listed in SAP for the associated vendor number)

*The address provided above shall be the same as the vendor billing address that is listed in the SAP system for the associated vendor number. In order to do business with the Commonwealth of Pennsylvania, providers are required to enroll in the SAP system.

Research Priority (Check only one box): Spinal Cord Injury Research:

☐Tier 1: Pilot Research Grant ☐Tier 2: Standard Research Grant ☐ Tier 3: Clinical/Translational Research Grant

Principal Investigator-Primary Contact

Name: (First Name, MI, Last Name) ______________________________________________________________

Position Title: ________________________________________________________________________________

Telephone Number: (Area code, number and extension) _______________________________________________

Direct Email Address: __________________________________________________________________________

Degree(s): ___________________________________________________________________________________

Mailing Address:

Secondary Contact for the Grant Coordinator

Name: (First Name, MI, Last Name) _______________________________________________________________

RFA #67-211

Attachment I

Position Title:_________________________________________________________________________________

Telephone Number: (Area code, number and extension) _______________________________________________

Direct Email Address: __________________________________________________________________________

Degree(s):___________________________________________________________________________________ Mailing Address:

Administrative Contact (to be notified when funds become available)

Name: (First Name, MI, Last Name) ______________________________________________________________

Position Title: ________________________________________________________________________________

Telephone Number: (Area code, number and extension) _______________________________________________

Direct Email Address: __________________________________________________________________________

Mailing Address: ______________________________________________________________________________

Applications received shall remain valid, unless deemed unresponsive, until such time that final award(s) is or are made.

BY SIGNING BELOW, THE APPLICANT, BY ITS AUTHORIZED SIGNATORY, IS BINDING ITSELF

TO THE APPLICATION AND REPRESENTING THAT ALL THE INFORMATION SUBMITTED IS

TRUE AND CORRECT TO THEIR BEST KNOWLEDGE, INFORMATION AND BELIEF.

Signature of Applicant’s Authorized Official Date

Name and Title of Applicant’s Authorized Official

Applicant Name:
Type of Legal Entity:
Grant Amount:
SAP Vendor:
Federal ID:
Address 1:
Address 2:
City:
County:
State:
Zip Code:
Tier 1 Pilot Research Grant: Off
Tier 2 Standard Research Grant: Off
Tier 3 ClinicalTranslational Research Grant: Off
Name First Name MI Last Name:
Position Title:
Telephone Number Area code number and extension:
Direct Email Address:
Degrees:
Mailing Address:
Name First Name MI Last Name_2:
Position Title_2:
Telephone Number Area code number and extension_2:
Direct Email Address_2:
Degrees_2:
Mailing Address_2:
Name First Name MI Last Name_3:
Position Title_3:
Telephone Number Area code number and extension_3:
Direct Email Address_3:
Mailing Address_3:
Applications received shall remain valid unless deemed unresponsive until such time that final awards is or are:
Date:
Name and Title of Applicants Authorized Official:

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