Pennsylvania Association of PeriAnesthesia Nurses

                                                          
                                 Research Grant Application Form

Project Title: ________________________________________
Institutional Review Board (IRB) Approval if applicable
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Phone:  (H) ___________________ (W) __________________
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PAPAN/ASPAN membership number:  ___________________

Co-Investigators: _____________________________________
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Advisor's Name and Title: _____________________________
Advisor's Address:  ___________________________________

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