SRA Quick Form

MSSM PI Name *

Sponsor Institution/Company *

Sponsor Contact

Sponsor Contact Email *

What amount of funding with the sponsor provide? *

Initially, who reached out to whom with the idea of entering into this agreement? Did you reach out to the Sponsor or did the Sponsor reach out to you? *

Briefly describe the research you will perform with this funding. *

What is the length of time the research will take? *

Who created the research plan / protocol for this project? Was it you, the company, or a joint effort? *

Are you an inventor on any issued patent or pending patent application, or any invention disclosure, related in any way to the research project to be performed under this agreement? *

Will your lab receive additional support for this research (in addition to the sponsor) from a third party, Federal, State, philanthropic foundation, or an additional sponsoring company? *

YesNoStateFederalPhilanthropicIndustry

Will you also receive materials and/or equipment from the collaborator? *

YesNo

Will materials or equipment received (not purchased) from any party other than the collaborator be used in the research? *

YesNo

Do you have any issued or pending patents, or have you ever filed an invention disclosure related in any way to this research? *

YesNo

Do you have any concerns regarding the terms of the agreement provided by the other party? If Yes, Please describe below *

YesNo

If you answered Yes above, please describe

Please fill out the SRA Quick Form below. A member of OTBD’s Contracts Team will receive the form and follow up with you as soon as possible.

Sponsored Research Agreement (SRA) Quick Form

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