Thank you for your interest in applying for the ACDS Outcomes Research Grant. Please complete the below information and submit by the designated deadline to be considered for the grant. Please contact email@example.com or call 414-918-9805 with any questions you might have.
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Fiscal Officer to whom payment should be directed. Note: Without complete and accurate information for this section, checks cannot be mailed.
Please upload your submission below.
Please include a page listing the Fiscal Officer, the Project Director (or Applicant), Department Head and the Dean/Administrative Official along with their signatures agreeing to the statement below.
Grantee shall indemnify, defend and hold harmless American Contact Dermatitis Society (ACDS) and its officers, directors, members, agents and volunteers from and against all claims, damages, losses and expenses (including reasonable attorneys' fees) arising out of or in connection with the actions or inactions of Grantee, Principal Investigator, and Co-Investigator in connection with the Study, including, without limitation, any claims or actions based upon or arising out of damage or injury (including death) to persons or property, or claims for payment or non-payment, caused by or sustained in connection with the performance of the Study.
[ ] Agree
[ ] Do not agree