Chicago Biomedical Consortium (CBC) Online Application Submission

Chicago Biomedical Consortium online application submission page

*Please note that we currently DO NOT offer the feature to save your responses and/or to return and complete the application at a later time. If you are unable to complete the application in full at this time, we advise that you take screenshots of what you have completed already for future reference.

I. APPLICANT INFORMATION

Eligibility *

To be eligible to apply for an award, applications must include at least one Research Faculty or Tenure Track Faculty at one of our nine partner institutions. Applicants must have their own designated laboratory space. Please contact Jessica Irons (Jessica.irons@northwestern.edu) for questions about eligibility.

Faculty Status

I am tenured or tenure-track faculty

I am research faculty member

I have my own designated laboratory space

Yes

Intellectual Property

The intellectual property described herein has been licensed to a company

The intellectual property described herein has NOT been licensed to a company

Submitter’s Information *

Enter your personal information below as PI #1. If there are additional co-PIs, please check YES at the end of each submitter section to add information for the next PI.

Name of PI #1 *

First

Last Name of PI #1 *

Last

Degree

(e.g. MD, PhD, MD/PhD)

Title

(e.g. Professor, Associate Professor, Assistant Professor)

Institution *

Add information for PI #2?

Yes

PI #2 Info

Name of PI #2 *

First

Last Name of PI #2 *

Last

Degree

(e.g. MD, PhD, MD/PhD)

Title

(e.g. Professor, Associate Professor, Assistant Professor)

Institution *

Add information for PI #3?

Yes

PI #3 Info

Name of PI #3 *

First

Last Name of PI #3

Last

Degree

(e.g. MD, PhD, MD/PhD)

Title

(e.g. Professor, Associate Professor, Assistant Professor)

Institution *

Add information for PI #4?

Yes

PI #4 Info

Name of PI #4 *

First

Last Name of PI #4

Last

Degree

(e.g. MD, PhD, MD/PhD)

Title

(e.g. Professor, Associate Professor, Assistant Professor)

Institution *

Add additional PI information?

Yes

Additional PI Info

Include full name(s), degree(s), title(s), institution(s) and email(s) of all additional PIs

Please click 'Next Page' to continue onto Page 2.

If you are human, leave this field blank.