Form SCR-1 "Qualified Research Institution Request for Approval" - New Jersey

What Is Form SCR-1?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the New Jersey Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SCR-1 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.

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New Jersey Commission on Spinal Cord Research
QUALIFIED RESEARCH INSTITUTION
REQUEST FOR APPROVAL
The New Jersey Commission on Spinal Cord Research requires that the organization or institution of a grant applicant
be approved as a qualified research institution prior to the submission of a grant application.
If your organization or institution appears below, you do not need to submit this document. Those organizations or
institutions that have not been approved, and are not listed below, must apply.
Qualified Institutions
University of Medicine and Dentistry of New Jersey
Rutgers, The State University of New Jersey
Princeton University
Coriell Institute for Medical Research
2/2/03
Kessler Foundation
Stevens Institute for Technology
1/11/05
Kessler Institute for Rehabilitation
Wyeth Research/Pfizer
5/19/05
5/19/05
New Jersey Institute of Technology
Progenitor Cell Therapy, LLC
12/2/10
9/25/03
TRIM-edicine, Inc.
Drew University
11/14/13
Hackensack University Medical Center
Seton Hall University/School of Health & Medical
12/18/03
12/18/03
Science
JFK NJ Neuroscience Institute/JFK Health System
6/18/15
Celvive, Inc.
VA NJ Health Care System & Veterans Biomedical
6/17/04
9/17/15
Research Institute
Montclair State University
11/25/18
Rowan University/Cooper University Hospital/Medical
St. Joseph’s University Medical Center
5/20/10
School & Health Systems
The completed form can be sent electronically to
NJCSCR@doh.nj.gov
or by mail to The New Jersey Commission
on Spinal Cord Research, 369 South Warren St., P.O. Box 360, Trenton, New Jersey 08625-0360.
If you have questions related to the completion of this form, please call the Commission office at 609-292-4055.
Name of Institution/Organization:
1. Is this Institution/Organization capable of receiving and administering federal and state grants?
Yes
No
2. Does this institution/organization have a Grant Administration Office (or equivalent) that is responsible
for overseeing grant programs?
Yes
No
IF YES, please list the grant administrator’s name, address, and phone number:
Administrator’s Name:
Address:
Room:
City:
State:
Zip:
Phone:
Email:
IF NO, please explain what type of fiscal oversight structure your institution/organization has in place:
SCR-1
NOV 18
Page 1 of 2 Pages.
New Jersey Commission on Spinal Cord Research
QUALIFIED RESEARCH INSTITUTION
REQUEST FOR APPROVAL
The New Jersey Commission on Spinal Cord Research requires that the organization or institution of a grant applicant
be approved as a qualified research institution prior to the submission of a grant application.
If your organization or institution appears below, you do not need to submit this document. Those organizations or
institutions that have not been approved, and are not listed below, must apply.
Qualified Institutions
University of Medicine and Dentistry of New Jersey
Rutgers, The State University of New Jersey
Princeton University
Coriell Institute for Medical Research
2/2/03
Kessler Foundation
Stevens Institute for Technology
1/11/05
Kessler Institute for Rehabilitation
Wyeth Research/Pfizer
5/19/05
5/19/05
New Jersey Institute of Technology
Progenitor Cell Therapy, LLC
12/2/10
9/25/03
TRIM-edicine, Inc.
Drew University
11/14/13
Hackensack University Medical Center
Seton Hall University/School of Health & Medical
12/18/03
12/18/03
Science
JFK NJ Neuroscience Institute/JFK Health System
6/18/15
Celvive, Inc.
VA NJ Health Care System & Veterans Biomedical
6/17/04
9/17/15
Research Institute
Montclair State University
11/25/18
Rowan University/Cooper University Hospital/Medical
St. Joseph’s University Medical Center
5/20/10
School & Health Systems
The completed form can be sent electronically to
NJCSCR@doh.nj.gov
or by mail to The New Jersey Commission
on Spinal Cord Research, 369 South Warren St., P.O. Box 360, Trenton, New Jersey 08625-0360.
If you have questions related to the completion of this form, please call the Commission office at 609-292-4055.
Name of Institution/Organization:
1. Is this Institution/Organization capable of receiving and administering federal and state grants?
Yes
No
2. Does this institution/organization have a Grant Administration Office (or equivalent) that is responsible
for overseeing grant programs?
Yes
No
IF YES, please list the grant administrator’s name, address, and phone number:
Administrator’s Name:
Address:
Room:
City:
State:
Zip:
Phone:
Email:
IF NO, please explain what type of fiscal oversight structure your institution/organization has in place:
SCR-1
NOV 18
Page 1 of 2 Pages.
QUALIFIED RESEARCH INSTITUTION
REQUEST FOR APPROVAL
(Continued)
3. What type of grants does the institution/organization hold? Please check those that apply :
National Institutes of Health (NIH)
National Science Foundation (NSF)
State or other Government Agencies
Private and Corporate Foundations
Other (please specify):
4. Does your institution/organization provide for the protection of human subjects, animal welfare, and
recombinant DNA molecules as regulated by the National Institutes of Health?
Yes
No
IF NO, please explain:
5. Does this institution/organization have in place an Institutional Review Board (IRB) that will approve
proposed research?
Yes
No
6. Please provide information on any ongoing funding that the institution/organization receives in regard to
grants. (
Attach additional sheets if necessary.)
7. Please provide information on any affiliation agreements with any other institutions/organizations that
the institution/organization may be an affiliate of. (
Attach additional sheets if necessary.)
SCR-1
NOV 18
Page 2 of 2 Pages.
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