Engineering Research Grant COI Disclosure
Full Name
Position/Title
Department
Grant Title
Funding Agency
1. Financial Interests
Do you have any significant financial interests related to this research grant?
No
Yes
If yes, please describe:
2. Relationships/Activities
List any relationships, activities, or affiliations (e.g., advisory roles, consulting, board memberships) that could influence, or appear to influence, your work for this grant.
3. Intellectual Property
Do you have any intellectual property interests (e.g., patents, copyrights) that are related to the grant?
No
Yes
If yes, please describe:
4. Other Potential Conflicts
Are there any other situations or affiliations that may represent a conflict of interest?
Date
Signature