Dr. Elena M. O’Connell Memorial Fund Fund for Education and Outreach

Complete the form below to submit your application.

EM OC Fund Application

Name

First Last

Phone

Title of Project

Primary Objective

Tertiary Objective(s)

Proposed Timeline

Additional Team Members, Co-Authors

Please list additional names and their respective roles. Use a new line for each person and comma separate.

Project Lead

Please paste or upload a formal letter of intent describing the project in detail. There is a separate section for budget.

Option to Upload Letter of Intent

Max. file size: 1 GB.

Please upload a formal letter of intent describing the project in detail

Option to paste letter of intent

Please paste or upload an itemized project budget.

Option to Upload Project Budget

Max. file size: 1 GB.

Option to Paste Project Budget

Has ethics approval been obtained?(Required)

Yes

Other Funding Sources

Please disclose other funding sources for your project.