letter of collaboration request form

Introduction

LetterofCollaborationRequestForm ThisformwillcollecttheinformationneededtodraftaLetterofCollaboration(LOC).Pleaseensurethedatayouprovideisaccurateandcomplete.Youmaysavethisformandreturntoitatalaterdateusingthesamecomputerandbrowserfromwhichyouinitiatedtheform.Thelinktothisformwillexpireafterthreemonthsofinactivity. UsethisformonlyforLettersofCollaboration.PleasecontactInternationalAffairsifyouwishtoenterintoadifferenttypeofagreement.   Youcannavigatetheformbyclicking   intheupperleftareaofthescreen.You'llfindforwardandbackbuttonsatthebottomofeachpage,alongwithanindicatorshowingyourprogressthroughtheform. WeuseDocuSigntocollectsignatures,aswellastodistributefully-executedcopiestoallsignatoriesandotherdesignatedrecipients.Pleasebesuretouseworkemailaddressesforallpartiestothisagreement.WecannotdistributeLettersofCollaborationtopersonalemailaddresses.

AbouttheSubmitter

AboutYouAreyouthefacultymemberdevelopingandconductingthiscollaboration? 

Ifyouarecompletingthisformonbehalfofthefacultymemberorganizingthecollaboration,pleaseprovideyourinformationsowecancontactyouwithquestions.

Iamthepersondevelopingtherelationship.

Iamsubmittingthisrequestonbehalfofsomeoneelse.

FirstName

LastName

OSUEmailAddress

OSUPhoneNumber

OSUAdministrativeLeadRole

PurposeofAgreement

PurposeoftheAgreementListanyanticipatedareasofcollaboration,activities,andresearchcoveredbythisagreement.

AreyouawareofanycurrentorpastcollaborationsbetweenOSUandthispartner?

OSUAdministrativeLead

Yes

No

Pleasedescribethenatureandstatusofthesecollaborations.

PartnerInstitutionInformation

PartnerInstitutionNameandAddressPleaseusethefullnameofthepartnerinstitution,inEnglish,andthemainaddressoftheinstitution.Thisinformationprovidedwillbeusedtodrafttheagreement,andwillbeusedinaddressingemailcommunications.

PartnerInstitutionFullLegalName

AddressLine1

AddressLine2

City

State/Province

Whatcountryisthepartnerlocatedin?

PartnerInstitutionLead

PartnerInstitutionLeadCollaboratorPleaseprovidethefollowinginformationaboutthepersonwithwhomyouarecollaboratingatthepartneringinstitution. (Thisisthepersonatthepartnerinstitutionresponsibleformonitoringandmaintainingtheactivitiesofthispartnership.)

Postalcode

PrimaryContactFirstName

PrimaryContactLastName

PrimaryContactRole

EmailAddress(attheinstitution)

FullnameasitwillappearontheLetterofCollaboration.Forexample:Dr.HansSchmidt.

CollegeorDepartmentName

Phone

PartnerInstitutionSignatories

PartnerInstitutionSignatoriesPleaseidentifythepeoplewhowillsigntheLetterofCollaborationonbehalfofthepartnerinstitution.Ensureallinformationisaccurate,asthisinformationwillbeusedtocreatetheLOC.Providethesigners'universityorinstitutionemailaddresses.Typically,oneortwoindividualswillsigntheLOConbehalfofthepartner. Pleaseincludethesignatureblock,asyouwouldlikeittoappearontheLOC,foreachsignatory.Forexample: KendraV.Sharp,Ph.D.SeniorAdvisortotheProvostforInternationalAffairs FirstPartner Institution Signatory

FirstName

LastName

Salutation

EmailAddress(attheinstitution)

SignatureBlock

Doyouwanttoaddanothersignerforthepartnerinstitution?

Second Partner Institution Signatory

Yes

No

FirstName

LastName

Salutation

SignatureBlock

Doyouwanttoaddanothersigner forthepartnerinstitution?

Third Partner Institution Signatory

EmailAddress(attheinstitution)

Yes

No

FirstName

LastName

SignatureBlock

Doyouwanttoaddanothersigner forthepartnerinstitution?

Fourth Partner Signatory

Salutation

EmailAddress(attheinstitution)

Yes

No

FirstName

SignatureBlock

OSULead

OSULeadPleaseprovidethefollowinginformationabouttheOSUfacultyorstaffmemberproposingtheLetterofCollaboration.Thispersonisresponsibleformaintainingtheactivitiesofthispartnership.

LastName

Salutation

EmailAddress(attheinstitution)

LeadFirstName

OSULeadRole

LeadLastName

FullnameasitwillappearinthebodyoftheLOC.Forexample:Dr.JohnSmith.

CollegeorDepartmentName

OSUEmailAddress

OSULead

OSUSignatory

OSUSignatory PleaseidentifythecollegeordepartmentalsignatoryforthisLetterofCollaboration.ThisisoftenthecollegeDean,andinlargercollegesmaybetheassistantorassociatedeanwhodirectlyoverseesyourunit.Thesignatoryistypicallysomeoneotherthantheagreementlead.WhileLOCstypicallyhaveonedepartmentalsignatory,wecanaccommodateadditionalsigners.OSU'sSeniorInternationalOfficerisalsoasignatoryonallLOCs. Includethesignatureblock,asyouwouldlikeittoappearontheLOC,foreachsignatory.Forexample: KendraV.Sharp,Ph.D.SeniorAdvisortotheProvostforInternationalAffairs 

FirstName

LastName

Salutation

OSUEmailAddress

SignatureBlock

Do youwanttoaddanotherOSUsigner?

SecondOSUSignatory

Yes

No

FirstName

LastName

SignatureBlock

DoyouwanttoaddanotherOSUsigner?

ThirdOSUSignatory

Salutation

OSUEmailAddress

Yes

No

FirstName

SignatureBlock

ExecutedAgreementDistribution

ExecutedAgreementDistributionTherequesterandcollaborator,aswellaseachsignatory,willreceiveacopyofthefullyexecutedagreement. Shouldanyoneelse,forexample,collegeadministrativestaff,receiveacopyoftheexecutedagreement?Ifmorethanoneadditionalpartyrequiresacopyoftheagreement,pleasecontactouroffice.

LastName

Salutation

OSUEmailAddress

Sendacopytothefollowingperson:

AdditionalRecipientRole

SubmitRequestForm

Yes

No

RecipientFirstName

RecipientLastName

RecipientEmailAddress

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SubmittingYourRequest Beforesubmittingyourrequest,pleasereviewtheinformationyouareproviding.Youcanjumptoanypartoftheformusingthenavigationlinks intheupperleftofthescreen. Itisnotpossibletoedittherequestformonceitissubmitted. Whenyousubmitthefollowingpage,yourrequestwillbeforwardedtoInternationalAffairs.Youwillbepresentedwithasummaryoftheinformationsubmitted.Werecommendyoudownloadthisinformationasa.pdfdocument,andsaveitforreferenceasweprocesstheagreementrequest.Pleaseallowupto10businessdaystoreceivearesponse.