Accession No. ⁽²⁾ _____

DEPARTMENT(s): _________________________________________________________

MAILING ADDRESS: ____________________________________ PHONE: ____________

PROJECT TITLE ⁽³⁾_____________________________________________________

OBJECTIVES:___________________________________________________________

______________________________________________________________________

PERSONNEL:
1.    Professional    ___________________    ___________________    ___________________

2.    Technical        ___________________    ___________________    ___________________

FUNDING:        _____    Farm             Account # ______________   Amount $___________
                          _____      Project         Account # ______________   Amount $___________

LOCATION:    Station: _______________ Location & Acreage: ___________________

Do the activities of this project require approval by the Institutional BioSafety Committee? ___ YES ___ NO

Date of planting or initiation: __________ Approx. Completion Date:___________

PROCEDURE AND MATERIALS: (give details, including experimental design. Use & attach additional pages if needed)





¹ Agreement must be completed in full and signed, at least annually, before work can be initiated.
²Assigned by the Dean's Office.
³Must correspond to approved project, demonstration or teaching plan on file in Dean's Office unless prior arrangements have been made with Farming Superintendent and approved by the Dean's Office.

APPROVED:

____________________________    ___________    ____________________________    ___________
    Project Leader                                        Date                   Resident Director                              Date

____________________________     __________    ____________________________    __________
    Department Head                                    Date                   Director/Experiment Sta.              Date

_____________________________     ___________
    Farm Superintendent                             Date                              PLEASE TURN OVER & FILL OUT
                                                                                                    CROP PROD. RESPONSIBILITY SECTION.

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