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SARC Concept Proposal Form
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Email *

I. Principal Investigator (first author)

a. Name:

 *

b. Institution 

 *

c. Mailing address: 

 *

d. Telephone 

 *
e. Email address: *
Co-Principal Investigator (co-first author)
a. Name
 *

b. Instution 

c. Mailing address:
d. Telephone:
e. Email address:

II. Mentorship (senior author)

 *
III. Concept Title *
IV. Investigational Agent *

V. Study Population

 *
Disease(s) included, eligible ages, key inclusion/exclusion criteria (keep brief):
RATIONALE & STUDY DESIGN
VI. Rationale for study
 *

VII. Objectives

Primary Objectives:

 *

Objectives

Secondary objectives: 

 *
VIII. Study Design
Have you discussed this with a SARC statistician?
 *
Study Design
Number of patients (in total and by treatment group): 
 *
FEASABILITY
IX. Study Duration 
Estimated number of sites:
 *
Study Duration 
Estimated duration of accrual:
 *
Study Duration
Estimated number of cycles per patient:
 *
Study Duration 
Duration of follow up:
 *
SCIENCE
X. Biomarker Assessment / Correlative Studies
 *
XI. References
 *
XII. Estimated Budget
If you need assistance in developing your preliminary budget (for example, for a grant application), please let us know. 
XIII. Funding Source(s)
 *

SARC is a study sponsor and coordinator, similar to a contract research organization (CRO). SARC does not financially support trial conduct.

Please document whether funding is pending or secured.

If you are need a Letter of Support from SARC for grant applications or other funding requests, please make a note here.

A copy of your responses will be emailed to the address you provided.
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