Research Western

Final Report Form for Western Internal Grants

Please provide award recipient details for the following.

IMPORTANT: This form will not time-out, but leaving or closing the page before clicking the "Submit" button at the bottom of the page will erase all entries. Consider first writing responses in a Word document or similar and pasting them into this form when ready.

For assistance, contact Research Development and Services at or call ext. 84500

* indicates required fields.

        • Internal Grant: *  

      • Project Title: *
Award ID (8 characters; e.g., R1231A23): *
ROLA Proposal ID (5 digits): *
PI First Name: *
PI Last Name: *
Faculty: *
PI Email Address: *
PI Phone Ext (5 digits): 

Final Report Details:

      • Please disclose what was accomplished by receiving these internal funds, and include any anticpated outcomes.
      • Impact on Research: *
        Describe how this internal support has progressed your research work, including any future deliverables or development expected.  
      • Benefits to Others: *
        Describe how this internal support has benefitted others, whether collaborator(s), HQP, research colleagues, and include whether new collaborations were established both nationally and internationally.  
      • Publication Activity: *
        List any publication activity (including published abstracts) generated from this internal support and disclose whether author or co-author.  
      • Dissemination Activity: *
        Disclose any other dissemination activity arising from this internal support, including conference presentation invitations, website development, generated media exposure and so forth.  
      • Other Funding Sources: *
        List other funding secured as a result of receiving this internal support. Please indicate the granting source(s), award amount, grant duration and whether the PI or Co-Applicant. If none, please enter, "None." 
      • Awards and Distinctions: *
        List any award or distinction recognition received as a result of the research work completed with this internal support. If none, please enter, "None."  
      • Additional Comments:
      • b.c.c. Additional Email Addresses:
      • To send a copy of this submission to multiple emails, separate email addresses with only a comma.

  Please review your form prior to submission.  Thank you for your final report.