{"text_format":"3","workbook":"xlsx","n_sheets":2,"sheets":["Application","Budget Worksheet"],"not_rendered":{"images":2,"defined_names":3},"read":"whole","date_system":"1900"}

{"sheet":"Application","index":0,"n_rows":94,"n_cols":4,"rows_kept":94,"merged":[[0,0,0,5],[1,0,1,5],[2,0,3,5],[4,0,4,1],[4,2,4,5],[5,0,5,5],[6,0,6,1],[6,2,6,5],[7,0,10,1],[7,2,10,5],[11,0,11,1],[11,2,15,5],[12,0,15,1],[16,0,16,5],[17,0,17,1],[17,3,17,5],[18,0,19,1],[18,2,19,2],[18,3,19,5],[20,0,20,1],[20,2,20,5],[21,0,23,1],[21,3,21,5],[22,3,22,5],[23,3,23,5],[24,0,24,1],[24,2,24,5],[25,0,26,1],[25,2,26,5],[28,0,33,5],[34,0,34,5],[35,0,35,5],[36,1,36,5],[37,1,37,5],[38,1,38,5],[39,1,39,5],[40,0,40,1],[40,2,40,5],[41,3,41,5],[42,3,42,5],[43,3,43,5],[44,3,44,5],[45,0,45,5],[46,0,46,5],[47,0,55,5],[56,0,56,5],[57,0,57,5],[58,0,58,5],[59,0,62,5],[63,0,63,5],[64,0,64,5],[65,1,65,5],[66,0,67,5],[68,0,68,5],[69,1,69,5],[70,1,70,5],[71,1,71,5],[72,1,72,5],[73,1,73,5],[74,0,76,2],[74,3,76,5],[77,0,77,5],[78,0,81,5],[82,0,82,5],[83,1,83,5],[84,1,84,5],[85,1,85,5],[86,1,86,5],[87,1,87,5],[88,0,90,2],[88,3,90,5]]}
[]
["TITLE OF PROJECT"]
[]
[]
["2. TYPE OF PROJECT "]
["Complete section below that coordinates with your project type (choose one):"]
["2a. Patient Care\n",null,"2c. Research"]
[]
[]
[]
[]
["2b. Education    ",null,"Please note:\nIf SCRIHS/IACUC approval is applicable, a copy of the approval letter must accompany this application.  Failure to secure final SCRIHS/ IACUC approval before submitting this application will result in automatic rejection.  "]
[]
[]
[]
[]
["3. APPLICANT INFORMATION"]
["Name:  ",null,"Degree(s): ","Phone Number: "]
[]
[]
["Title and Department:",null,"Mailing Address:"]
[null,null,"Street:"]
[null,null,"City:"]
[null,null,"State/Zip: "]
["Organization: ",null,"Email Address:"]
["Southern Illinous University School of Medicine"]
[]
["Organization Mission Statement (for organizations other than MHS):"]
["SIU School of Medicine was established in 1970 with a mission to educate physicians to remain in central and southern Illinois. "]
[]
[]
[]
[]
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["4. GRANT ADMINISTRATION INFORMATION"]
["a. Application Questions"]
["Contact Name:","Grants Office"]
["Title:","Grants Office"]
["Phone Number:","217-545-4549"]
["Email Address:","grants@siumed.edu"]
["b. Budget Questions (if contact is different from a.)",null,"c. Award Notification (if contact is different from a.)"]
["Contact Name:","Grants Office","Contact Name:","Grants Office"]
["Title:",null,"Title:"]
["Phone Number:",null,"Phone Number:"]
["Email Address:  ",null,"Email Address:  "]
["5. Project Executive Summary and Narrative:  "]
["a.  Please provide a brief executive summary and how MMCF funds will be used in project. (maximum length 200 words):  "]
{"$rows_empty":9}
["b. Have you applied to the Foundation for this project in the past?   "]
[" "]
["Please note:"]
["You may attach a more detailed project narrative. If you choose to do so, title it Project Narrative for \"[title of grant application]\". \nYou may address, in layman's terms, the project:\n     1. objectives\n     2. expected outcomes\n     3. anticipated timelines\n     4. impact on patient care, education, and/or research in support of Memorial's mission to improve the health of the people and communities we service. Maximum length three pages (1/2\" margins, Arial 11 pt.)"]
[]
[]
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["6. PROJECT BUDGET"]
["Total amount requested from Memorial Medical Center Foundation (calculated automatically upon completion of budget worksheet): Please note that registration fees paid for conferences must be remitted to MMC Foundation and will reduce the total grant award."]
["Net Grant Request",{"$f":"'Budget Worksheet'!F23","v":{"v":0,"d":"$0.00"}}]
["7. ACCEPTANCE AND TERMS AND CONDITIONS\nI, the undersigned, confirm that this application is true and correct.  I understand that if funding is awarded for this application I will be responsible for assuring that a final report, and where required, an interim report is submitted to the Foundation in a timely fashion."]
[]
["Please print or type:"]
["Name"]
["Title:"]
["Street:"]
["City:"]
["State/Zip: "]
["Signature:",null,null,"Date:"]
[]
[]
[]
["8. OFFICIAL SIGNING FOR APPLICANT ORGANIZATION\n(MHS SLT Member / University Grant and Contract Office Representative / Non-Profit Executive Director)\nI, the undersigned, confirm that this grant application is designed to further patient care, education and/or research, and I support its submission to Memorial Medical Center Foundation for proposed funding."]
[]
[]
[]
["Please print or type:"]
["Name","Donald S. Torry, PhD"]
["Title:","Associate Dean for Research"]
["Street:","801 N. Rutledge / PO Box 19616"]
["City:","Springfield"]
["State/Zip: ","IL/62794-9616"]
["Signature:",null,null,"Date:"]
[]
[]
[]
["Application and Budget Worksheet must be submitted in Excel via e-mail to foundation@mhsil.com by 4:30 PM on February 1."]
["One paper copy must be delivered to the Foundation office at 1000 Churchill Rd. by 4:30 PM on February 1. "]

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[]
["Project Name: ",{"$f":"IF(ISBLANK(Application!A3),\"Please type in Title of Project as Stated in #1 of the Application\", Application!A3)","v":"Please type in Title of Project as Stated in #1 of the Application"}]
["BUDGET DETAIL FOR BUDGET PERIOD",{"$nulls":3},"FROM","THROUGH"]
[]
["1.  PERSONNEL",null,null,"DOLLAR AMOUNT REQUESTED (omit cents)"]
["Name","Role in Project"," Please identify institution (SIU, MMC, etc.)","Salary Requested","Fringe Benefits","Total"]
[{"$nulls":5},{"$f":"ROUND(SUM(D7:E7),0)","v":{"v":0,"d":"$0.00"}}]
[{"$nulls":5},{"$f":"ROUND(SUM(D8:E8),0)","v":{"v":0,"d":"$0.00"}}]
[{"$nulls":5},{"$f":"ROUND(SUM(D9:E9),0)","v":{"v":0,"d":"$0.00"}}]
[{"$nulls":5},{"$f":"ROUND(SUM(D10:E10),0)","v":{"v":0,"d":"$0.00"}}]
["SUBTOTAL",{"$nulls":4},{"$f":"SUM(F7:F10)","v":{"v":0,"d":"$0.00"}}]
["2. Capital Equipment (final quote must be attached):"]
["3. Equipment (final quote must be attached):"]
["4.  Printing, Postage, Copying"]
["5.  Consumables/Commodities (itemize by category on separate sheet)"]
["6.  Patient Care (provide detail on separate sheet)"]
["7.  Consultanting, Contractual or Speaker Services (itemize by category on separate sheet)"]
["8. PC Hardware/Software (itemize by category on separate sheet)"]
["9. Other Expenses (itemize by category on separate sheet)"]
["10. TOTAL COSTS FOR BUDGET PERIOD",{"$nulls":4},{"$f":"ROUND(SUM(F11:F19),0)","v":{"v":0,"d":"$0.00"}}]
["12. In-Kind Support (itemize funding from other sources on separate sheet)"]
["13. Additional conference revenues, sponsorships or grants (itemize funding on separate sheet):"]
["14. TOTAL REQUESTED (minus in-kind support and other anticipated revenue)",{"$nulls":4},{"$f":"F20-F22","v":{"v":0,"d":"$0.00"}}]
["15. Is this project viable with partial funding?  Please explain"]