Material Transfer Agreement Request Form for INBOUND Material

PLEASE NOTE: If the research involves human subjects OR is being funded by the provider of the materials, DO NOT USE THIS FORM. Contact your school’s Office of Research Administration (ORA or JHURA) for assistance.

"*" indicates required fields

Submitter Name*
I am the JHU faculty member.*
Type of Entity (Select One)
Check all material types that apply*
Do alternative sources of the material exist or is the material commercially available? (Select One)
How will the material be used in the research?*
Check all that apply
Do you anticipate Reports of Invention to result from the use of the Material(s) under this MTA? (Select One)
Is there any JHU Intellectual Property (Reports of Invention, patents, pending patents applications, proprietary research property, or copyright) associated with the research in which the Material(s) will be used? (Select One)
Will the material be used or co-mingled with materials received from another organization? (Select One)
Is the JHU Scientist receiving this material as a straightforward transfer of materials and not as part of a larger/broader collaboration with Providing Scientist? (Select One)
15. Is this material needed for a proposal under development or consideration for funding? (Select One)
Indicate the type of funding source(s) for this research. Check all that apply
Check all that are true about the material
Will the research using the material(s) be under any of the following? Check all that apply
At present, or in the 12 months prior to this agreement, do any investigators or their family members have a financial or non-financial relationship with the Provider Organization of the materials?*
If "YES," contact your Office of Policy Coordination.
Max. file size: 20 MB.
Acceptable file types: doc, docx, pdf, txt, gif, jpg, jpeg, png. Maximum file size: 20mb.
Max. file size: 20 MB.
Max. file size: 20 MB.
Max. file size: 20 MB.
This field is for validation purposes and should be left unchanged.

Please confirm all required fields are completed. Upon submitting, a confirmation will be sent to the email address provided.

To initiate a request for a Material Transfer Agreement (MTA), complete the fields above. A member of the Contracts Group at Johns Hopkins Technology Ventures (JHTV) will promptly review your request and assist you.