Letter of Support Request

Letter of Support Request

To request a letter of support, please complete and submit the online form below. Requests for letters of support should be submitted at least 7 business days prior to the date needed.

The form requires you to attach a draft letter in Word format. We strongly recommend that the letter is customized to your specific proposal and unique to other letters of support you may be submitting in your application.

Letters are subject to review, editing and approval and will be signed by the Department Chair.

A PDF of your signed letter on DEM letterhead will be returned back to you or emailed to the person you specify in the form below.

Last Name, First Name*

Email Address*

If your Primary Department is not Emergency Medicine, please list your home department.

If your Home Department is Emergency Medicine, leave this section blank.

Purpose of Letter*

i.e. Grant Application, Nomination to Committee, etc. and where is the letter going (i.e. NIH, etc.)

Deadline for Submission*

Grant Submission Deadline

Deadline for your LOS Request*

Please allow a minimum of 7 business days

Final Proposal Title (if applicable)

Link to Funding Opportunity (if applicable)

If you prefer to attach the funding/award opportunity, use the Attachments section at the bottom of this form.

Special Letter of Support Requirements

Please list any requests/requirements for this LOS. Examples include specific information that must be included in the letter, elements of the letter that should not be edited by DEM, any expectations for support from the Department that need to be included (financial, protected time, etc), special forms that must be used, etc.

Additional Information (if any)

Name(s) and Contact Information for the person/people who should receive the final document.*

After the LOS has been signed, we will email an electronic version of the letter to the designated contact person. Some grants require LOS be sent directly to the agency. If this is the case, please provide full details about where the signed letter should be sent and other information needed to submit the LOS. Multiple names are allowed.

Attachments*

Required - Draft Letter of Support in Word format

Optional - attach your grant abstract/proposal summary, funding/award announcements, fully application page, CV, or any other documents that may be helpful. This field allows for multiple attachments.

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