Banting Research Foundation Discovery Award Application 2018

Complete all items and submit electronically as a PDF to: . Use the following conventionin naming your document: LastnameFirstname_BRFApplication_2018.pdf.Attachments, including letter of nomination from Dept/Div Head, may be included in this PDF or combined in a single separate PDF named LastnameFirstname_attachments_2018.pdf.

Mail/courier the original application with signatures to:

Banting Research Foundation

6 Queen’s Park Crescent West, Rm 10

Toronto ON M5S 3H2

Emailed documents must be received by March 15, 2018, 5:00 pm ET.The original hard copymay be mailed or couriered the next day, or shortly after, but must be in our hands to consider your application complete.

For text portions, use 12 pt Times New Roman, single-spaced with no condensed type or spacing, and do not alter the ½” margins of this document. Applications that do not follow these guidelines may be removed from the competition at our discretion.

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Applicant's name, position/rank, department, faculty, institution:

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Mailing address, telephone, email address:

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Institution at which work is to be carried out:

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Short title of research project:

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Summary of funds requested:

A.$Salary & benefits

B.$Materials and supplies

C.$Equipment

D.$Other (specify)

$Total (must not exceed $25,000)

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Name, title, mailing address, telephoneand email address of official in business office responsible for administering the research grant and to whom cheques should be sent if grant is awarded.

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Acceptance of a grant constitutes an agreement that:

  • The requirements and conditions governing the award of a research grant by the Banting Research Foundation, as posted on our website November 2017, are hereby accepted by the applicant and the institution that employs the applicant.

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Signatures:

ApplicantDepartment/Division Head/Chair*Authorized Officer of Institution

(eg, VP Research or equivalent)

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Name:Name and title:Name and title:

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Date:Date:Date:

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*Note: The Department/Division Head/Chair may nominate only one applicant per grant competition. Letter of nomination must be included.

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Name of applicant-

Details of Funds Requested

Names and qualifications of salaried persons if available should be given. Briefly justify the amount requested in each budget category. Please append quotations for any equipment and justify the availability and status of similar equipment.

A.$Staff - salary

- benefits

B.$Materials and supplies

C.$Equipment

D.$Other (specify)

$Total (must not exceed $25,000)

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Lay language summary of proposed research. Approximately 100-150 words, in everyday language comprehensible to the general public and suitable for publication on our website. (If you’re not sure it is in everyday language, please test it on someone outside the realm of biomedical research.)Provide 3 to 5 keywords to identify field of research or health conditions the work can be applied to.

Note: please also paste this lay language summary and keywords into your cover email so that it can be copied and distributed to potential reviewers.

Keywords:

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Name of applicant-

Summary of research proposal

The objective(s), hypothesis, approach and research plan should be summarized in this section. Be sure to describe how this request for funding fits into your overall program of research. Please keep this section to ½ page.12pt Times New Roman, single-spaced.

Summary of previous work on this or closely related programs by the applicant.

Refer briefly to published work and identify how the work has advanced the state of knowledge in the field in this section. Please keep this section to ½ page.

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Name of applicant-

Research Proposal

Provide a clear, concise description of the research proposal, in a maximum of 3 pages. It should describe the current state of knowledge about the work proposed, including relevant work done by the applicant, clearly delineate the objectives and research plan,provide a rationale for choosing particular methods and approach, and the expected results. Be sure to describe how this request for funding fits into your overall program of research and how the funding is expected to impact your research activities. Relevant references and figures can be included on up to 5additional pages. 12pt Times New Roman, single-spaced.

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Name of applicant-

Personal Data

A EDUCATION (including Bachelor, Master’s, Doctorate, Clinical Training and License)

DegreesUniversity/Institution and locationScientific fieldSupervisorYear

B RESEARCH TRAINING (Postdoctoral & post health professional training)

DatesInstitutionDepartmentSupervisor

fromto

C ACADEMIC POSITIONS HELD and HOSPITAL APPOINTMENTS

DatesInstitutionDepartmentPosition

fromto

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Name of applicant-

Publications

Please include a complete list of your publications, separated into the following categories: 1) papers published, in press, and submitted; 2) published abstracts and 3) any outreach articles online or in the popular press. Use additional pages if necessary. One or two manuscripts most relevant to this application may be appended.

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Name of applicant-

Presentations

Please include a complete list of your presentations, separated into 1) invited conference speaker, 2) invited seminar speaker, and 3)public presentations.

Name of applicant-

Other Funds

List all sources of support (active and currently applied for) including operating funds from external sources and institutional support such as start-up funds. Use additional pages if necessary. Do not include copies of the summary or budget pages of grants currently held or applied for.

Name of applicantFunding agencyTitle of projectAmount/yearStatusSupport

and co-applicantsHeld/AppliedPeriod

Updated: November 2, 2017

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