Application for CCSG Co-Pay

Please complete the attached form and click “SUBMIT.”  Your application will be reviewed by the CCSG Executive Committee and you will receive a response within one month.

1) Title of Funded
Research Project

2) Your Name

3) Name of PI

4) Project PTAO

 - - -

5) Sponsor

Please provide name of funding agency, period of award and grant number. (E.G. NIH R01 AI99999-04; 2/1/05-1/31/09; "Role of ..."

6) Abstract and Specific Aims of Your Research Project

7) Justification

In ½ page, explain the cancer relevance of your project. If it is a collaboration with another CC investigator, please summarize the nature of the collaboration.
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