Department of Biostatistics, Bioinformatics, and Biomathematics (DBBB) and BBSR Project Request Form
This form should be used by Principal Investigators or their Designated Contact Person to provide information about their research project, including funding source.  A completed form must be submitted to the Department of Biostatistics before any work can be begin.

IMPORTANT: For grant submission/conference abstract submission, please allow us to have at least 4 weeks ahead of a deadline.

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Email *
Principal Investigator (PI) Name *
Principal Investigator (PI) Email address *
Principal Investigator (PI) Phone *
Affilliation *
Required
If LCCC affiliated, please select a program *
If non-LCCC, please enter your full affiliation, company name, address, etc.
Designated Contact (Requester): NAME & TITLE *
If the same as Principal Investigator (PI), enter "See Above".
Designated Contact (Requester): EMAIL address *
If the same as Principal Investigator (PI), enter "See Above".
Designated Contact (Requester): PHONE *
If the same as Principal Investigator (PI), enter "See Above".
DBBB Member requested *
Please indicate the faculty or staff member with whom you would like to collaborate on this project. The Department will try to accommodate your request.  However, we reserve the right to assign a different member to your project depending on the members' availability, expertise, etc.
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