Application Form for “FY2021 IMSUT International Joint Research Project”

(New Project / Extension) * *Select one of two choices

To: Dean, the Institute of Medical Science,

the University of Tokyo

Principal Investigator

Name
Title
Institution
Address
Country	Zip code
E-mail
Tel	Fax

IMSUT Host Researcher

Name
Division, Title
E-mail
Tel

I hereby apply for “IMSUT International Joint Research Project” as follows.

Research Area and Topic *Select one of three choices	□ (1) Development of Cutting-Edge Medical Therapies □ (2) Genome/Cancer/Disease Systems Biology □ (3) Infectious Diseases and Immunology
Project Title
Project Purpose
Duration	*For extension applicants: Fill in your entire study period. *The duration is up until March 31, 2022, at the longest. From until Year(s)
Estimated Expenses for FY2021 Project	Expenses	Items
Travel Expenses	Expendable Supplies, etc.
(JPY)	(JPY)	(JPY)
Details: e.g.) 4 nights (Twice)	Details: e.g.) Reagent: 100,000 JPY

Project Members *Write all members including the IMSUT faculty staff.
Name	Institution/ Department	Title	Role

Research Plan	* If project duration extends over multiple fiscal years, describe both the entire and yearly research plans. *The research plan needs to be feasible even in the pandemic of COVID-19.
Facilities to be Used
Anticipated Research Results from the Project
Status of Preparation
Grants Awarded and Papers Published Related to the Research Proposal