Program Submission Form

Don't Let Your Cancer Control Research Go Unheard. Here is How to Get Started...

OMB No.: 0925-0740

Expiration Date: 07/31/2022

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0740). Do not return the completed form to this address.

Attention

Before completing the form below, please refer to the outcomes matrix for a list of RTIPs topic areas and related primary and secondary outcomes.

Provide Information about your Intervention

1.
       
2.
       
3.
       
4.
       
5.
       

Enter your Contact Information

Updated: 12/12/2012