Research Request Form

Community or Organization Name *

Iowa County *

Primary Contact Email *

Primary Contact Phone Number *

Please choose one of the following: *

I am interested in collaborating with the University of Iowa on research based in my community.

I am interested in having the University of Iowa conduct specific research in my community.

I am interested in partnering with the University of Iowa on a grant application.

I am interested in a different form of grant support from the University of Iowa.

Research or Grant Support details *

Please be as descriptive as possible.

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