Industry-Sponsored Research or Services Form

Please complete the information below. Please also set up a meeting with Dr. Linda Chamberlain.

Faculty Information

First Name *

Last Name *

Email *

Campus Address (Room Number & Building) *

Industry Partner Information

Organization/Company *

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

First & Last Name of the Organization/Company Contact *

Email of the Organization/Company Contact *

Phone Number of the Organization/Company Contact *

Do you or any family member (defined as spouse, domestic partner, and/or dependent children) have any financial or equity interest in this organization? *

If YES, see the GVSU Faculty Conflict of Interest Guidelines.

Project Information

Describe the Project *
Please enter at most 1000 characters. You currently have entered 0 characters.

TIME FRAME FOR THE PROJECT

Project Begins *

Project Ends *

PROJECT BUDGET DETAILS
(Proposed Budget for Contract)

Personnel *
Faculty
GA(s)
Student(s)
None

Projected Cost of Faculty *

Projected Cost of GA(s) *

Projected Cost of Student(s) *

Equipment *

Projected Cost of Equipment *

Materials and Supplies *

Projected Cost of Materials & Supplies *

Travel *

Projected Cost of Travel *

Other Costs *

Describe the other costs and amount needed. *

Total Direct Funds *

Total Indirect Funds *

Total Budget for Project *

OTHER PROJECT INFORMATION

Do you anticipate intellectual property to result from this project? *

This project involves *
Human subjects or animals, or their blood/material/fluids
Pathogens/Biohazards
Hazardous/Regulated chemicals, radioisotopes
Recombinant DNA, stem cells or stem cell lines
None of the above/Not applicable

Is the organization based in the USA? *

Does this project require an Export Control and Open Research Review Plan? *

Will the organization agree to use the GVSU Services Agreement? *

Human Verification *

Page last modified March 31, 2026

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