Community-Based Research Case Study Compendium Submission Form

Project Title:

Project URL:
Project Purpose or Mission:


Project Partners and their Roles: (specify lead organization)





Funding Source(s): (optional; e.g. indicate if public, private, foundation, or multiple)


Project Start Date:					Project End Date:

Description of Project
* Aims and desired outcomes:

* Population affected:

* Research approach: (methods and any results)

* Other project activities:

* Utility of partnership for the approach:

Key Project Publications/Materials: (journal publications, books, videos, please include location, i.e. website etc.)




Key Researchers/Project Staff:





Key words:	(e.g. AIDS education & prevention; arts & culture; diversity; economic development; education; environment; international; mental health; substance use; urban planning; youth development)


Contact Person:
* Title: 
* Affiliation:
* Mailing Address:
* Organization Website:
* Email:
* Phone:
* Fax:

Date submitted:


     



* We reserve the right to make grammatical adjustments to submissions.  Final format will returned to contact person via email, with a response deadline, for final approval.