Name *

First Name

Last Name

Preferred Phone *

(###)

###

####

I have emailed my CV to cgkgmayes@gmail.com *

Yes

No

Select All That Apply *

AORN Member

eChapter Member

I have received funding from another source*

I have pursued professional development ** opportunities

Is this a group proposal *

Yes***

No

***if there are additional investigators, I have emailed their CVs to cgkgmayes@gmail.com *

Yes

No

Study/Project is associated with a Dissertation/Thesis/Course project? *

Yes

No

Human Subjects/Institutional Review Board Approval *

Will your research/project require approval by the Human Subjects Review/IRB before data collection begins?

Yes

No - it is exempt (confirmed by an IRB)

Not yet determined

Statement of Understanding *

I will follow the guidelines stated here

I have read, understood, and followed the eChapter Research Project Grant guidelines

My research project proposal contains a detailed budget with quotes.

My proposal contains references to previous work in the field.

My proposal contains a clearly stated question and design.

I will present my results to eChapter BOD, Research Committee and membership and submit an AORN Expo poster/presentation/AORN journal article proposal.

I agree to participate in periodic eChapter Research Committee reviews of the research project.

I will submit a copy of receipts demonstrating funding usage within 1 week of project completion