It is the responsibility of the proposal writer to inform the Department Chair in the case of an academic department, or the Department Director in the case of an administrative department of the potential impact upon teaching load, advising, committee service, department support services or any other effect on University administration. Furthermore, the grant proposal writer is responsible for obtaining all signatures five(5) days before the date of submission. Please make sure all information is complete on this form.

Submitted by (proposal writer): _______________________Date:  _____________
Deadline by which proposal must be submitted: _____________________________

Department Chair or Director: __________________________ Date:___________

School Dean or Supervisor:     _________________________ Date: ___________

Vice President IITS                _________________________ Date: ___________
IF THE PROPOSAL REQUIRES TECHNOLOGY EQUIPMENT OR SERVICES THIS SIGNATURE IS REQUIRED.

Grants Office:                          _________________________ Date: ___________

Human Resources:                   __________________________Date:___________

VP for Administration
and Finance:                            _________________________ Date: ___________

Vice President: (of area)          _________________________ Date: ___________

VP Inst. Advancement or Dir. of Corp and Foundation Relations:

                                              _________________________ Date: ___________ 
IF THE PROPOSAL IS SEEKING SUPPORT FROM A PRIVATE FOUNDATION, BUSINESS, INDUSTRY, OR INDIVIDUAL, APPROVAL TO MAKE THE REQUEST MUST BE GIVEN BY INSTITUTIONAL ADVANCEMENT BEFORE THE PROPOSAL IS DRAFTED.

Granting Agency Funding Amount                  $ ________________

Required Longwood University Cash Match      $ __________Banner Account _______
Required Longwood University In-Kind Match  $ ___________Banner Account_______

THIS ORIGINAL FORM ALONG WITH A COPY OF THE PROPOSAL MUST BE SENT TO SYLVIA SCHUTT IN THE ACCOUNTING AND FINANCIAL REPORTING OFFICE (GRANTS OFFICE - LANCASTER 213C)  AFTER ALL SIGNATURES ARE COMPLETED.