Please answer the following questions. When you are finished and submit the form, you will receive an on screen confirmation, please print the confirmation for your records.

A help sheet with reminder items and checklists will be generated based on the answers you provided and the information will be sent to your GCSU email account. The intent of the reminder information is to guide and assist through the grants process. When you submit the form, your proposal will be assigned a number. Please keep this number for future use.

If you have any questions or need assistance, please call Office of Grants and Sponsored Projects at 445-3497.

• Indicates a required fields

Personal Information

•  1. Name of individual writing the proposal       a. First Name      b. Last Name

•  2. Email Address       (only use GCSU email)

•  3. Department  Choose Department Academic Affairs -- Sandra Jordan Academic Engagement -- Sara Faircloth Academic Outreach -- Ruth Eilers Accounting -- Catherine Whelan Administrative Services and Campus Operations -- Paul Jones Admissions -- Suzanne Pittman Art -- William Fisher Athletics -- Wendell Staton Auxiliary Services -- Kyle Cullars Biological and Environmental Sciences -- Indiren Pillay Business Office/Financial Services -- Candace Kobbe Business, Dean -- Dale Young Campus Life -- Tom Miles Center for Student Success -- Mike Augustine Chemistry, Physics and Astronomy -- Ken McGill Communities In Schools -- Sandy Baxter Continuing Education -- Artis Williamson Counseling Services -- Mary Jane Phillips Coverdell Institute -- Gregg Kaufman Digital Innovation Group -- Jim Wolfgang Disability Services -- Mike Chambers Diversity Programs and Services -- Jennifer Graham Early Childhood & Middle Grades Education -- Nancy Mizelle Economics & Finance -- Ken Farr Education, Dean -- Jane Hinson English and Rhetoric -- Elaine Whitaker Extended University -- Mark Pelton Financial Aid -- Cathy Crawley Foundations and Secondary Education -- Brian Mumma GC at Robins AFB -- Howard Woodard GIVE Center -- Kendall Stiles Government and Sociology -- Olufunke Fontenot Health Sciences, Dean -- Sandra Gangstead History and Geography -- Stephen Auerbach Honors Program -- Steven Elliott-Gower Human Resources and Employee Relations -- Carol Ward IDEAS -- Wesley Smith Information Systems & Computer Science -- Tanya Goette Interdisciplinary Studies -- Sunita Manian International Education Center -- Dwight Call Kinesiology -- Lisa Griffin Library and Instructional Technology Center -- Joe Mocnik Macon Center for Graduate and Professional Learning -- Kendra Russell Management -- Michael Whitfield Marketing -- Joe Schwartz Mass Communication -- Mary Jean Land Mathematics -- Robert Blumenthal Milledgeville Community Connection -- Ken Farr Modern Languages and Cultures -- Larbi Oukada Museum Education Room -- Nancy Davis Bray Music Department -- Victor Vallo Music Therapy -- Chesley Mercado National Middle School Association -- John Lounsbury Network and Systems Administration -- Charles Taylor Nursing -- Judith Malachowski Office of Afterschool Achievement -- Linda Watson Kaufman Office of Grants and Sponsored Projects -- Robin Lewis Office of the Division of Information Technology -- James Carlisle Office of the President -- Paul Jones Old Governor's Mansion -- Jim Turner Outdoor Education -- Jude Hirsch Printing Services -- Jon Scott Psychology -- Lee Gillis Public Safety -- Scott Beckner Registrar's Office -- Kay Anderson Special Education and Educational Leadership -- Craig Smith Student Health Services -- Alice Loper Technology Support Services -- James Carlisle The Science Education Center -- Rosalie Richards Theatre Department -- Karen Berman University Broadcasting -- Bill Wendt University Housing -- Larry Christenson Wellness and Recreation Center -- Dave Terrell

Proposal Information

• 4. Title of project

• 5. Content/Purpose of project:  Choose one Conference Equipment Facilities Instruction Public Service Research

•  6. Brief overview of concept or idea Word count:

7. Other individuals involved with the proposal:  (optional)

• 8. Estimated amount to be requested:  $

•  9. Do the grant guidelines allow for indirect cost recovery?    Yes     No    Do not know

•  10. Project period:  Start Date: Month May June July August September October November December January February March April Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022    through End Date: Month May June July August September October November December January February March April Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

•  11. Have you identified a funding source for your proposal?     Yes     No a. If yes, Type of agency: Choose one Federal Local Private - RESEARCH PROPOSAL ONLY Professional Association State b. Name of sponsoring agency:

•  12. Proposal Submission deadline:   Month May June July August September October November December January February March April Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

•  13. Does the sponsoring agency require proposals be submitted electronically?    Yes     No    Do not know

•  14. Does the proposal include purchasing equipment?    Yes     No    Do not know

•  15. Will the proposal involve the purchase of any hardware, software, or networking components to implement or support the project?   Yes     No    Do not know

•  16. Will the project involve collaborating with other institutions, organizations, or corporations? Please identify.   Yes     No

•  17. Does this project involve the use of human subjects?   Yes     No

•  18. Does this project involve the use, purchase or housing of animals?   Yes     No

19. University Commitments  a. Are matching funds required by the sponsor? Yes    No    Do not know b. What type of match is required? cash   In-Kind c. Identify amount of the required match.    $

20. What kind of assistance do you need to prepare the proposal for submission? (check all that apply)  a. Proofreading assistance b. Assistance with grant guidelines and procedures c. Budget items and planning d. Other - please elaborate below

NOTE: Conflict of Interest Disclosure form is required for all external grant applications and must be submitted to the Office of Grants and Sponsored Projects before the proposal can be forwarded to the sponsor.