RFA 67-211 Letter of Intent Form.pdf
PDF 177 KB Posted
- Attached to
- Spinal Cord Injury Research Grant
- Solicitation number
- RFA 67-2011
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This is a Letter of Intent Form for RFA 67-211, a Spinal Cord Injury Research Grant administered by the Commonwealth of Pennsylvania. The form serves as the initial submission requirement for organizations seeking to conduct research aimed at improving the health of Pennsylvanians living with spinal cord injuries, in accordance with Act 77 of 2001. Applicants must complete and submit the Letter of Intent Form as a prerequisite to full proposal submission. The form establishes the applicant's eligibility and commitment to participate in the grant program while providing preliminary project information for preliminary review by the granting agency.
The Letter of Intent Form functions as a gatekeeping mechanism to filter applications and ensure that proposed research aligns with program objectives before resources are invested in full proposal evaluation. Submission of this form is mandatory for consideration and typically includes basic organizational information, project title, research focus area, and confirmation of the applicant's capacity to conduct the proposed research. The form's completion demonstrates the applicant's serious intent to pursue funding and allows the granting agency to conduct initial administrative and programmatic vetting before advancing applications to the detailed review stage.
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Text version
RFA# 67-211
Attachment IX
Letter of Intent
Pennsylvania Department of Health
Letter of Intent to Submit an Application for Spinal Cord Injury Research Grant
In Response to
RFA 67-211
Email to:
RA-HEALTHRESEARCH@pa.gov
Health Research Office Attention: Administrative Officer Pennsylvania Department of Health 10th Floor, Room 1033, Health and Human Services Building, 625 Forster Street Harrisburg, PA 17120-0701 Telephone: (717) 547-3103
Due date: on or before the date and time specified in the cover letter to the RFA
Typeface and Font size - Use Times New Roman font size 10 pts. or larger.
The Principal Investigator of the lead institution and the collaborating institutions, specified in this letter, intends to submit an application to the Pennsylvania Department of Health at the time, date and address specified in the cover letter to the RFA. The letter of intent is nonbinding. The letter of intent is used to plan for the peer review process.
Applicant Institution:
Federal ID (EIN) #:
Collaborating Major Research Organization(s) Located in Pennsylvania and the Name of the Lead Investigator at Each Organization:
Name of Principal Investigator:
Position Title:
Other Collaborating Institutions and the Name of the Lead Investigator at Each Institution:
Telephone:
Email Address:
Mailing Address:
Focus of the Research Project (check one category): Spinal Cord Injury Research: ☐Tier 1: Pilot Research Grant;
☐ Tier 2: Standard Research Grant; ☐ Tier 3: Clinical/Translational Research Grant Title of the Research Project (no more than 81 characters including spaces and punctuation):
mailto:RA-HEALTHRESEARCH@pa.gov
Research Project Description (not to exceed 2 pages)
| Tier 2 Standard Research Grant: Off |
| Tier 3 ClinicalTranslational Research Grant: Off |
| Tier 1 Pilot Research Grant: Off |
| undefined: |
| Title of the Research Project no more than 81 characters including spaces and punctuation: |
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| Research Project Description not to exceed 2 pages: |
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