Cancer HTS Drug Discovery Initiative (CHDDI) Application Form Last Name(Required) First Name(Required) Title/Position(Required) Department(Required) UF Health Cancer Center Research Program(Required)Cancer Control and Population SciencesCancer Targeting and TherapeuticsImmuno-Oncology and MicrobiomeMechanisms of OncogenesisEmail(Required) Phone(Required)Primary mailing address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Has this project been submitted to the CHDDI before?(Required) Yes No Title of project (non-confidential)(Required) This is a mechanism to support HTS on projects that will integrate and create synergy with UF Scripps and other UF Health Cancer Center members at Gainesville or other UF sites.Use Field 1 to describe the project background. Field 2 is a visual aid for how the biology works in the screen. Field 3 is to describe HTS assay materials and methods. Field 4 is to list material transfer agreements, grants & collaborations, outside funding availability, and publication goals. *Also include, separately, your NIH biosketch with current support. The amount of screening in terms of small molecules and libraries will be determined upon review of the application but at a minimum will allow for the preliminary data to be acquired for an NIH grant submission.Is funding available for this project? If yes, state why you wish to use UF Scripps in Field 1).(Required) Yes No Target name(Required) Target class(Required) Pharmacology probed(Required)ActivatorAgonistAntagonistInhibitorOtherPotentiatorAssay type(Required)BiochemicalLive Cell-BasedOtherCurrent detection method(Required)AbsorbanceFluorescenceLuminescenceNone InvestigatedOtherTime-Resolve FluorescenceProtocol format (Homogeneous = assays that don’t require reagent removal or wash steps; heterogenous assays can have reagent removal, wash steps, fixing etc.)(Required)HeterogeneousHomogeneousOtherAssay format(Required)384-well plate96-well plateIn vitroNone of the aboveOther microtiter platePositive/negative controls(Required)Both availableNegative onlyNone availablePositive onlyField 1: Project background-HTS amenability and references. Raw data not required.(Required)Maximum 250 wordsField 2: Attach graphical diagram of the assay biology that demonstrates how the biology and detection method works in the screen.File(Required)Max. file size: 125 MB.Field 3. Materials and Methods-Reagent Supply-Scalability(Required)Maximum 250 wordsField 4: Material Transfer Agreements, Grants & Collaborations, Outside Funding/Future Goals, and Publication Goals. Other funding/support can be appended as a combined PDF with your biosketch.(Required)Maximum 250 wordsUpload combined NIH biosketch and other funding support pages.(Required)Max. file size: 125 MB.