Biomedical Sciences Summer Student Research Funding Application

Please complete the application, ensuring to answer all questions below and submit to the Vice Dean’s Research Office by February 29th, 2016. The application will be completed by both the student and the supervisor for one potential project. Text boxes will expand as you complete the application. Size of the text box does not indicate length of answer; please provide adequate information for each section.

Project Details

This section is to be completed by the student with guidance from their supervisor.

Project Title

Start DateEnd Date

Project TypeChoose one

Research TypeChoose one

If other please specify:

Background – Please provide the background details of this research. Why is thisproject important?

(500 word maximum)

Hypothesis –A clear statement of the research question(s) and hypothesis(s). Both are important. This must clearly relate to the background material. (250 word maximum)

Methodology - Provide as much detail as required so that the reviewers can adequately review the validity of the approach taken to addressing the research question(s) and how it relates to the hypothesis(s).For example:What will be your sample size?(500 word maximum)

Project Assistance – Does this project require statistical analysis? ☐Yes ☐No

If Yes, please identify below who will be giving statistical advice on the design and analysis.(100 word maximum)

Timeline – Provide sufficient detail so that the reviewers can clearly review the feasibility of the study. How will the project be completed during the 16-week timeframe?What is the approximate date for completion of lab/field work/data collection? What is the approximate date for completion of data analysis?(200 word maximum)

Expected Outcomes –summarize the expected outcomes that will result from the project.(250 word maximum)

Significance - Significance of the research. If the project is successful, what is the expected significance of the project to the research program of the supervisor and the field of research in general? (250 word maximum)

Contingency Plan – If for unforeseen circumstances or if the research project is delayed for any reason, what will the student be required to do to gain research experience?(100 word maximum)

This proposal was written by: ☐The Student☐The Supervisor

Supervisor Portion

Name Email

Phone Number NSID Department

Needs Cancer Agency Approval: ☐Yes☐No If Yes Status:

Needs Cancer Registry Data: ☐Yes☐No

If Yes have arrangments been made with Agency and approval letter is attached: ☐Yes

**Note:The Cancer Registry requests all applications to work with their data be submitted by Dec. 15th to ensure review & approval.Please contact Serena Kozie (:639-625-2045) for more information.

Does this project require Ethics: ☐Yes☐No

Supervisor Background –Please complete the questions below if applicable.

Have you supervised an undergraduate summer student in a research project previously? ☐Yes ☐No
If Yes, in what year(s) and what was the name(s) of the student(s)?
Have you trained/mentored an MSc or PhD student?
Have you managed or been the principal investigator for a research project?
Have you taken the Tri-Council online training module on ethics?

Supervisor Expectations -- Please describe the work the student will be assigned, the learning goals for the student and who will be supervising the student throughout the term of the project. (250 words)

Project Assistance –Who else will be helping the student and will they be contributing to the publication (co-authorship or acknowledgement)?

Measures:
Person(s):
Publication Status:

Intellectual Property – Are there any pre-existing contracts that impact on the student’s ability to be listed as an author on a resulting publication?

Publications - If the data are sufficient to submit for publication, who is expected to write the first draft of the manuscript, and what will be the order of the authors?

Write First Draft:
Order of Authors:

Financial Support

Is research grant money and/or departmental financial support available to pay the balance of the stipend to the student for this proposal, as well as any operational funds that may be required? Yes No
Please specify the funding source that will be used (e.g.: fund number + source – CIHR, NSERC, SSHRC, Departmental, etc). ______

If Applicable:

Animal Protocol Number for this Project:
Biosafety Level I Registration Number:
OR Biosafety Level II Permit Number:

StudentPortion

Name Email

Phone Number NSID Year in program

Student Statement - Provide short statement describing why you want to be involved in research and this particular project.

Background - Please describe your background, experience and abilities that will allow you to competently and successfully deliver on this research project. (100 word maximum)

Deliverables - Please describe the duties and responsibilities you will be expected to deliver. For Example: What are the research training and learning objectives for you? Please be as specific as possible. (100 word maximum)

Agreement Acknowledged by Student and Supervisor

Please print off this portion of the application, ensure signatures are obtained below from both the supervisor and the student acknowledging the agreement and scan and submit with your project application or drop off the hard copy at the Vice-Dean Research Office – Room 2D01 Health Sciences Building. Applications will not be considered if this page is missing or incomplete.

I agree, to the best of my ability, that the information above is correct and that the duties and responsibilities have been mutually agreed upon by both parties.

I understand that the research project must be completed within the 16 week time frame and that both a report and poster presentation will be submitted based on the outcomes from the 16 week time frame. There will be no extensions granted regardless of circumstances.

I understand that if the student is dissatisfied with the supervision and has been unable to resolve the issue with the supervisor they may contact the Office of the Vice Dean Research for assistance.

I understand that if the supervisor is dissatisfied with the student preformance and has been unable to resolve the issue with the student they may contact the Office of the Vice Dean Research for assistance.

I understand by submitting a completed copy of this application I have agreed to the above terms.

Please complete below to varify agreement:

Student Name:

Signature:______

Date: ______

Supervisor Name:

Signature: ______

Date: ______

Department Head Name:

Signature: ______

Date: ______