Faculty Pre-Award Intake Form Faculty Name First Last FOA NumberTitle Period of Performance (Begins) MM slash DD slash YYYY Period of Performance (Ends) MM slash DD slash YYYY Budget InformationYears FTE Requested? Yes No Please provide students, travel and materials informationHave you given ScienCV Delegate Access for RAs? Yes No UFIRST QUESTIONSCo-PIs First Last Co-PIs First Last Co-PIs First Last Co-PIs First Last Subrecipients First Last Subrecipients First Last Subrecipients First Last Third Parties First Last Third Parties First Last Human subjects including human data or tissue or collection of data through surveys? Yes No Live vertebrate animals? Yes No Travel or send anyone working on this project to a location outside the US for more than 2 weeks in any one visit or more than 1 month over a 12 month period? Yes No Establish any relationships with foreign entities, individuals, or consultants; or have any of the work executed by a foreign entity, individual or consultant? Yes No Pay non-UF personnel salaries, wages, or any other compensation (including goods) for any work performed or engagement in activities outside the US? This includes field workers, research assistants, government representatives, participant payments, translators, drivers, or any other laborers. Yes No Transfer, ship, or pack in personal luggage for transfer out of the US any data, items, supplies, equipment, or materials purchased by UF or sponsored projects' funds? Yes No Perform any other activities not identified above outside the US or engage with any other entity, individual, or consultant outside the US? This does NOT include conference attendance. Yes No Interact with an individual from, ship to, import from, or travel to one of the following countries: Crimea, Cuba, Iran, North Korea, South Sudan, Sudan, Syria. Yes No If Yes, which one? For required institutional reporting purposes, provide lay abstract or key words (brief 1-2 sentences)