Internal Clearance Form Cost-Sharing Addendum



Indicate third-party volunteer or external entity contributed personnel services: Attach letter of support/commitment.
Name:
Entity:
Hourly Rate: x Hours:
Value of Contribution:
Period of Commitment: Signature of Dean
or PI

$ x
$


$ x
$


$ x
$

Combine to total in line 9.j. of Internal Clearance Form