Middlebury

 

Middlebury College Forms

Financial, Legal, & Compliance Forms

Grant Proposal Endorsement FormGrant Proposal Endorsement Form

This form is the "blue sheet" that is used for both Middlebury and MIIS proposals. A blue sheet is required for all proposals that entail a College commitment.

Middlebury researchers: Submit your blue sheet to the Sponsored Research Office with your proposed budget and all other required attachments

MIIS researchers: Submit your blue sheet, with your proposed budget and all other required attachments, according to MIIS procedures.

Need help filling out your blue sheet? Click here.

Not sure if you need one? Check here.

To request a hard copy of this form, contact Franci Farnsworth at x5889.

Use this form to request grant expenditures that differ from those described in the proposal budget. To read the policy that governs the Organizational Prior Approval System, click here.
 
Family Relationship Disclosure FormFamily Relationship Disclosure Form

Use this form to report family relationships between the PI and other grant-funded persons.

 Family Relationship Disclosure FormNIH Assurance Form            

If you are applying for NIH support, please submit a signed copy of  this form with your blue sheet.

 RCR Certification FormRCR Certification Form 

If your grant sponsor requires that you train student researchers in the Responsible Conduct of Research, use this form to document training.

PHS/NIH Financial Conflict of Interest Disclosure FormPHS/NIH Financial Conflict of Interest Disclosure Form

 Use this form if you are applying to or funded by any Public Health Service entity (including NIH, CDC, and VGN) to report “significant financial interests” related to your “institutional responsibilities” or to report that you have no such interests. See Middlebury's PHS/NIH Financial Conflict of Interest Policy for definitions of these terms.

PHS Travel Disclosure FormPHS Travel Disclosure Form

PHS-funded investigators: use this form for ad hoc disclosure of reimbursed or sponsored travel related to your institutional responsibilities. All supported travel must be disclosed unless it is funded through Middlebury or any other U.S. institution of higher education, hospital, academic medical center, or local, state or federal government.
 

Conflicting Financial Interest Disclosure Form

Use this form for all sponsors except Public Health Service entities to report “significant financial interests” that could potentially be a financial conflict of interest with the research or other activities funded by the external sponsor or to report that you have no such interests.

 
Sole Source Form
 
If you want to purchase equipment that costs more than $10,000 and don't want to collect written bids (required by College policy in most cases), you must you must submit this form to the Office of Grants & Contract Administration. More restrictions may apply.

Forms for Faculty Development & Research

Faculty Professional Development Fund Application

You must be logged in to Middlebury's network to access this form.

Leave Request Form

To download other Academic Administration forms, including Leave Support Notification (the "yellow sheet") and the voucher for requesting travel advances or reimbursement, click here.

Time and Effort Form

If your grant includes funding for summer salary, you must complete this online form. Click "Submit" when done to send it to the Grants Accounting Office for review. Once it's approved, your payment will be processed.

Vouchers

Use these forms to request payment (for example, reimbursement of travel expenses, honoraria and other payments to consultants, etc.).