Long Island University Logo
Brooklyn Campus, "Come Grow With Us


REQUEST FOR ASSISTANCE FORM


Please fill out the form below if you are in need of research assistance,
proposal development and project ideas.


* Required Filed's (please fill in the required fields before submitting)


* First Name:
  Middle Name:
* Last Name:
* Telephone Number: (Sample: 7181234567)
* E-mail  Address
* Name of Funding Agency and Program (if Known)
* Application date:
  Anticipated Submission Date
  Description of Project/Idea