Forms

All the forms can be viewed and printed as PDF documents (Adobe Acrobat Reader required).

If you need help completing the forms, please contact the OSRA office.

Downloads and Links
Adobe Forms D (NIH) – WCM Template NEW 01/31/2017
The Adobe Forms D package is to be used for due dates on or after May 25, 2016. This template is provided for reference purposes only, and is not intended to be completed for submission to NIH. For up-to-date application packages, visit the NIH website: http://grants.nih.gov/funding/index.htm and search for the appropriate Parent Announcement or RFA.
Adobe PDF
Addendum to Outside Consulting Agreement NEW 10/19/2016
Outside Consulting Agreements are considered to be personal arrangements between the WCM faculty member and the Company. WCM University Counsel requires this non-negotiable Addendum be signed by the Company and incorporated into the faculty member’s Outside Consulting Agreement.
Adobe PDF
Advance Account Request Form NEW 7/13/2016
As described in the form, this is for new and competing grants where WCM is prime and award notice is pending release from the Sponsor or processing is otherwise delayed. Submit request to initiate the set-up of a new account in order to commence work and allocate expenditures appropriately.
Adobe PDF
Annual Compliance Checklist NEW 1/13/2016 Adobe PDF
Budget Template - OSRA NEW 5/7/2015
The OSRA Standard Budget Template establishes a uniform model for use across all sponsored research funding. Use of this template will greatly assist OSRA as they review budgets and create accounts in SAP.
Microsoft Excel
Carryover Request Template Letter NEW 12/30/2016 Microsoft Word
Certificate of Registration for Use of Recombinant DNA or Transgenic Animals NEW 1/1/2010 Microsoft Word
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.
Microsoft Word
Consulting Agreement Template NEW 6/30/2016
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 8/13/2014
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 6/16/16 Adobe PDF
DUA Routing Form NEW 2/23/2015
Routing Form To Accompany Data Use Agreements (DUAs) For Incoming and Outgoing data and information to and from WMC.
Adobe PDF
Effort Reduction Template NEW 12/30/2016
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
Grant Transfer Checklist for PI Transferring FROM WCMC to NEW INSTITUTION NEW 12/12/2013
This form should be completed to the best of the ability of the Weill-Cornell Principal Investigator leaving WCMC and who wishes to transfer his/her grant(s) and/or contract(s) from WCMC to another organization.
Micorsoft Word
Grant Transfer Checklist for PI Transferring TO WCMC from FORMER INSTITUTION NEW 12/12/2013
This form should be completed to the best of the ability of the new Weill-Cornell Principal Investigator transferring his/her grant(s) and contract(s) to WCMC from another institution.
Microsoft Word
Guidance for Conflicts Disclosure NEW 1/1/2010 Adobe PDF
Hospital Facilities Form NEW 8/13/2014
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 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.
Microsoft Excel
(Intranet Only)
Human Subjects Protection Training Verification Form NEW 1/11/2017
The Human Subjects Protection Training form is completed to confirm that all WCM key personnel listed on a sponsored research project have completed the CITI "Biomedical Research Investigators and Key Personnel Course" web-based training.
Adobe PDF
Laboratory Safety Registration (replaces Research Safety Checklist / IBC Registration)
The "Research Safety Checklist/IBC Registration" and "Research Safety Checklist/IBC Registration - Short Form" have been replaced by the "Laboratory Safety Registration". Submit the Laboratory Safety Registration where prompted to upload the "Research Safety Checklist/IBC Registration". Environmental Health and Safety will assist researchers with obtaining your required IBC approvals for all of your laboratory's rDNA and biohazard work; Radiation Safety Committee approvals for all radioactive non-human use work; and the Research Safety Checklist for safety program implementation within the laboratory. Follow the link on the right to download the "Laboratory Safety Registration," follow all form instructions, and contact EHS at ehs@med.cornell.edu or 646-962-7233 with questions about the form.
Adobe PDF
Material Transfer Agreement (MTA) - Simple Letter Agreement (SLA) NEW 12/30/2016 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 NEW 8/13/2014 Adobe PDF
No Cost Extension Template NEW 12/30/2016 Microsoft Word
No Cost Extension Template (Non-Federal Sponsors) NEW 12/30/2016 Microsoft Word
Pre-Award Costs Request Template NEW 2/25/2015
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 2/25/2015
For any instance where a sponsored research project does not provide an approved indirect cost rate, please complete this waiver request.
Adobe PDF
Scope of Work Form NEW 8/13/2014
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
Statement of Intent to Establish a Consortium Agreement NEW 1/19/2017
A statement of intent form is required for all subcontract sites participating on a WCMC grant application. Please have the form completed and signed by your collaborator's central business office.
Adobe PDF
W-9 Form Adobe PDF
WBS Element Request Form NEW 06/27/2016
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