title-inside title-centered 2 CTBScience Request Form Please use this form to request information and assistance related to CTBScience Core activities. Name of Person Submitting Request First Last Email of Person Submitting Request *Please select if you wish to leave your organizational name and mailing address External Contact Info Company Phone Address City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code *These fields are not required If time sensitive, please request a deadline: Management Core - Research Development (clinical trials support, data use agreements, etc.) Research Development Clinical Trials Support Data Use Agreements Protocol Development Recruitment Resources Other Methods Core - Analytics Support (data management, analysis, etc.) Methods Core Data Management Data Analysis Bioinformatics Other Tech Core - Technology Innovations & Research (website, social media, eHealth) If you are wanting to submit a website and/or social media request, you are invited to use the detailed request form (link below) as the form captures all of the required information for web and social media publications: https://ctbscience.wufoo.com/forms/ctbscience-web-content-request-form/ *You do NOT need to complete the CTBScience Request Form if you complete the form linked above Tech Core Requests Website and Social Media Content eHealth Intervention Development Other Operations - Administration & Management (purchasing, travel, contracts & grants, etc.) Please keep in mind: Travel requests should be submitted at least 30 days in advance if at all possible. https://controller.vpfa.fsu.edu/travel Purchasing requests should allow for 5-30 days of lead time, to comply with University purchasing guidelines https://procurement.fsu.edu/policies New grant submissions require 30 days advance notice of the sponsor deadline https://med.fsu.edu/researchFundingFaculty/home *All requests must comply with Florida State University College of Medicine and University policies. Operations Requests Purchasing: please include the vendor, estimated amount, item(s), funding source, and other pertinent information in the description box below Travel: please include date(s) of travel, location, purpose, funding source, and other relevant information in the description below Human Resources: please select for assistance with re-appointments, new hires, time reporting, etc. Proposal Development: please include details related to the FOA or task type (e.g. sub award, RPPR, etc.) Community Engagement & Outreach: please include information related to marketing materials, community agencies, etc. Facilities & Room Reservations: please include the requested room number(s), date(s), purpose, and whether conference or other equipment is needed Other Please Include a Description of your Request Please upload any supporting documents here Upload Upload More Upload requirementsUnlimited number of files can be uploaded to this field.256 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Save DraftSubmit Reset
