CNICS Concept Proposal Extension or Close Request
Please complete the following form if you have received a notification regarding an extension for your approved CNICS concept proposal. Projects that have not been initiated by submission of a data request form or that fail to submit a progress report after one year from approval will be subject to closure unless a project extension form is submitted.
Full Name(*)
Please type your full name.
Please list your CNICS concept number or title(*)
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Institution(*)
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Decision (*)

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Reason for closing study
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Reasons for Extension



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Time Requested for Extension
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+Please specify below
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^If you have selected other, please specify below:
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Check here if you are willing to consider working with other interested investigators who wish to pursue similar studies through CNICS
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Comments
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(*)
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