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Name of this Application/Project:
PIs Name (if different):
Complete Mailing Address:
Please describe your project and outline the use of mice as part of this project. Your response need not be longer than a paragraph and can be adapted from a grant application.
Click to write the question text
Each of 12 Strains (male + female)
Each of 12 strains (male only)
Each of 12 strains (female only)
1. Is this a pilot project?
2. Is this an extension of a funded project:?
2b. If yes, please provide a one line summary of the funded project, funding source and duration.
3. Is this an integral part of a funded project?
3b. If yes, please provide a one line summary of the project, the specific aim that involves the use of diverse strains of mice, and the funding source and duration.
4. Does an active research protocol already cover your current use mice at UTHSC or the VAMC?
5. Are the types of experiments and studies you plan to conduct with CITG mice covered by your current protocol?
[You or one of your collaborators will need to have a valid protocol in place before mice can be transferred to the research program. This protocol will need to cover the use of the strains of mice and numbers of mice that we will provide you. We can help you with sample text for this purpose.]
6. In the last 12 months, roughly how many mice have you used in your research program?
Less than 20
20 to 100
More than 100
7. How many different types of mice have you used in the last 12 months (strains, transgenic, or knockouts)?
1 to 4
4 to 10
More than 10
8. Do you currently have mice at UTHSC that are maintained by the Department of Comparative Medicine?
9. Do you currently have mice at the VA Medical Center?
10. From where do you typically obtain mice (select one or more)?
Colleagues at other institutions
The Jackson Laboratory
Other major commercial vendors (Taconic, Charles River Laboratories, Harlan, etc.)Click to write Choice 4
11. Will you be sharing the mice or the tissues and cell derivatives with other researchers?
11b. If yes, please provide a one line summary of the funded project, funding source and duration.
12. If possible, please provide one or more PubMed ID number(s) that are most related to this application.
13. Please list important collaborators and their institutional affiliations (Name, Institution, Department).
14. If you are not the Principle Investigator, then please list the PI and ask him or her to jointly sign this application with you.
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