Grants/Contracts Forms

All the forms can be viewed and printed as PDF documents (Adobe Acrobat Reader required). Some documents are also available as MS Word documents. Hard copies of the forms can also be picked up at:

407 East 61st Street,
1st Floor
New York, NY 10065

If you need help completing the forms or you would prefer to have them mailed to you, please contact the RASP office.

Downloads and Links
Budget Forms NIH Format PHS 398 NEW 1/1/2010 Adobe PDF
Certificate of Registration for Use of Recombinant DNA or Transgenic Animals NEW 1/1/2010 Microsoft Word
Carryover Request Process and Template Letter NEW 3/13/2013 Micorsoft Word
Human Research Billing Analysis Form NEW 1/1/2010
Principal Investigators are required to submit one Human Research Billing Analysis Form per research protocol at the time of the IRB submission application for new protocols and again at the time of continuing review. The purpose of completing and submitting a Human Research Billing Analysis Form is to prospectively identify the list of services required by the study protocol, and indicate when the services will occur, who will provide the service, how the service is to be billed and in general terms, specify payment responsibility.
Web Link
Confidentiality Agreements NEW 12/1/2011
Template A: Outside Entity to Faculty/Investigator CDA
Template B: Cornell to Outside Entity CDA

Template A: This template should be used when the sponsor of a potential study is providing confidential information to a WCMC scientist/investigator.

Template B: This is template should be used when a WCMC scientist/investigator is providing confidential information to a potential sponsor.

Template C: This template should be used when both a WCMC scientist/investigator and a potential sponsor are providing confidential information to each other.
Microsoft Word
Conflicts Memo for ERF NEW 4/24/2013 Adobe PDF
Consulting Agreement Template NEW 1/1/2010
A consulting agreement is required for any consulting services budgeted on a sponsored project. The attached agreement is a non-negotiable template to be signed by any individual outside WCMC with the role of consultant on a funded sponsored project.
Microsoft Word
Cost Sharing Form NEW 1/1/2010
If institutional or Departmental funds will be used to support a portion of this project, please explain on the Cost Sharing Form.
Adobe PDF
DHHS Rate Agreement NEW 5/1/2013 Adobe PDF
Effort Reduction Letter Template NEW 8/20/2010
For all grants where an effort reduction approval is being requested from the Sponsor. For NIH, effort reductions greater than 25% should be submitted for key personnel named in the Notice of Award. For subawards and other Sponsors, follow the prime/sponsor agreement or notice of award guidelines.
Microsoft Word
Electronic Routing Form NEW 1/1/2010
User Guide
Web application
Equipment Survey Form NEW 1/1/2010
On a proposed sponsored project, complete this form for each proposed equipment purchase costing $5,000 or more. The Equipment Survey Form allows the Institution to confirm that the equipment is not already available on Campus.
Adobe PDF
Export Controls Checklist NEW 1/1/2010
"Export Controls" are those federal laws and regulations that govern the transfer or disclosure of goods, technology, software, services, and funds to restricted foreign countries, persons and entities (including universities). Your response to the questions in this checklist will help the Grants & Contracts Office and the Office of University Counsel determine whether any aspect of your sponsored research project activities will be subject to export control regulations.
Adobe PDF
Grants.gov Adobe-Forms C WCMC Template NEW 10/2/2013 Adobe PDF
Guidance for Conflicts Disclosure NEW 1/1/2010 Adobe PDF
Hospital Facilities Form NEW 1/1/2010
If a sponsored research project will be using any New York Presbyterian Hospital Facilities (space, ancillaries, personnel, data or information systems), a Principal Investigator must detail this use on the Hospital Facilities form.
Adobe PDF
Human Subject Education Form NEW 1/1/2010
The Human Subjects Education form is completed to confirm that all WCMC key personnel listed on a sponsored research project have completed the CITI Course in The Protection of Human Research Subjects web-based training.
Adobe PDF
Material Transfer Agreement (MTA) - Simple Letter Agreement (SLA) NEW 2/11/2013 Microsoft Word
MTA Incoming Routing Form NEW 12/05/2012
Routing Form To Accompany Material Transfer Agreements (MTAs) For Receipt of Material by WMC
Adobe PDF
MTA Scope of Work Form Adobe PDF
New York State Forms NEW 09/22/2011 NY State Tips | Access Formss
NIH Grant Application Face Page PHS 398 NEW 12/3/2012 Adobe PDF
NIH Grant Application Face Page PHS 2590 NEW 12/3/2012 Adobe PDF
No Cost Extension Request Form NEW 8/23/2011 Microsoft Word
No Cost Extension Request Form (Non-Federal Sponsors) NEW 7/25/2012 Microsoft Word
Preliminary Account Request Template NEW 1/1/2010
For non-competing grants where an award notice has not been received and the investigator is requesting access to an account to continue work and allocate expenditures to the project.
Microsoft Word
Advance Account Template NEW 9/7/2011
For new and competing grants where WCMC is prime and award notice is pending release from the Sponsor. Submit request to initiate the set-up of a new account in order to commence work and allocate expenditures.
Microsoft Word
Pre-Award Costs Request Template NEW 1/1/2010
For new, competing and non-competing grants for which a notice of award has been received with a later than anticipated start date and allowable pre-award costs is being requested.
Microsoft Word
Request for Reduction in Indirect Costs NEW 8/20/2013
For any instance where a sponsored research project does not provide an approved indirect cost rate, please complete this waiver request.
Adobe PDF
Research Safety Checklist/IBC Registration NEW 2/1/2011
After reading all instructions, direct any questions about the Research Safety Checklist portion to ehs@med.cornell.edu or 646-WMC-SAFE. For questions about the IBC Laboratory Registration portion, contact ibc@med.cornell.edu or 646-962-8285.
Adobe PDF
Research Safety Checklist/IBC Registration - Short Form NEW 1/1/2010
Do not submit this form unless you meet eligibility criteria per the Applicability portion of http://www/research-test/forms_and_policies/forms/research_safety.pdf.
Adobe PDF
Scope of Work Form NEW 1/1/2010
If a sponsored research project’s scope of work will involve any existing intellectual property and/or is likely to generate intellectual property, please indicate the details on the Scope of Work form. This form should not be used for subawards and consortiums where a scope of work is required.
Adobe PDF
Space Change Form NEW 1/1/2010
If your project will require alterations, renovations, or additional space, please detail this information on the Space Change form.
Adobe PDF
Statement of Intent to Establish a Consortium Agreement NEW 1/1/2010
(Not required by NIH)
Adobe PDF
Study Specific Report – Internal WCMC Use NEW 1/1/2010
(formerly the Study Specific Financial Disclosure)
Information & Help
Web Application
Study Specific Report – External Non-WCMC Use NEW 1/1/2010
(formerly the Study Specific Financial Disclosure)
Information and Forms
WBS Element Request Form NEW 04/05/2012
The purpose of this form is to ensure that all WBS elements (for new, competing and supplemental applications) are created with the appropriate levels of SAP access.
Adobe PDF