ACTRI Evaluation Service Request Form

ACTRI Evaluation Services Request Form
- Project Information
- Project Title
- Project Description (brief)
- Please specify the Evaluation service(s) you need:
- Supporting File(s)
  
  Browse Files
  If more than one, please upload as zip file! Cancelof
- PI Information
- PI First Name
- PI Last Name
- PI Full Name
- PI Email
  example@example.com
- PI Department
- Please indicate PI's ACTRI membership level:
- If you are not an ACTRI member yet, please click here to review membership eligibility criteria and submit your application. Once submitted, please select the applicable membership level from the above options to proceed.
- Contact Person Information
- Contact Person same as PI?
- Contact Name
  
  FirstLast
- Contact Email
  example@example.com
- Contact Department
- Recharge Information
- Please provide valid fund manager and OFC chart string information for recharge purposes.
  
  Click here to review current ACTRI recharge rates.
- Fund Manager Name
  
  First NameLast Name
- Fund Manager Email
  example@example.com
- OFC Project:
  Always required! (7 digit numerical value)
- OFC Task:
  Always required! (1-3 digit numerical value)
- OFC Funding Source:
  Required for sponsored projects only! (5-7 character alphanumerical value)
- Award #:
- Providing incorrect or incomplete OFC chartstring information will require further clarification and delay the process! Contact your fund manager or use the chartstring verification tool (requires VPN connection) to ensure chartstring accuracy prior to submission.
- Additional Information
- Funding Agency:
  
  Other
- Organizational Affiliation:
  
  Other
- Any further information or comments you would like to submit with this request:
- Request Date
  
  YearMonthDay
  DateHourMinutesAM/PM Option
- Eval Short Name
- Should be Empty:

ACTRI Evaluation Services Request Form