APPLICATION FORM

CHINA-CANADA Joint Health ResearchInitiative Proposal

A.Application Form

The complete and identical application must be submitted to both CIHR and NSFCwhich includes the Application Form and the following attachments.

The Canadian Nominated Principal Applicant must complete the following and provide a copy to their ChinesePrincipal Applicant to include in their package to NSFC:

(1)pages 1,2,5,6 and 7 from the CIHR Research Module, (Please insert the Chinese researcher as a Principal Applicanton page 2 of the Research Module by obtaining a CIHR PIN - Signatures of all Canadian applicants are mandatory on page 2. Signatures of Chinese researchers will be obtained if the grant is approved.

(2)theOperating Budget Module(Please include the full budget breakdown and justification between Canadian and Chinese costs in the budget justification.)

(3)a completed Common CV of the Canadian Principal applicants.

A1 / Title of Proposed Project
A2 / Main Subject Area
1 Neurosciences, Mental Health and Addiction
2 Human Development, Child and Youth Health
3 Cardiovascular
4 Diabetes and Obesity / 5 Cancer
6 Infection and Immunity
7 Aging
8 Gender and Health
A3 / Applicant Information
China / Canada
Organization / Organization
Name of the Project Leader / Name of the Project Leader
Address / Address
Tel/Fax / Tel/Fax
E-mail / E-mail
A4 / Other CollaboratingParticipants and Institutions
China / Canada
A5 / Project Period
from to
(month) (year) (month) (year)
A6 / Budget Request
China / Canada
1st year / RMB / 1st year / CDN$
2nd year / RMB / 2nd year / CDN $
3rd year / RMB / 3rd year / CDN $
total / RMB / Total / CDN$

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B. Project Details (see Request for Applications)

B1. Project Abstract (not to exceed this page)

B2. Project Description (not to exceed a total of 5 pages)
-detailed description of research project including objectives, background, literature review, proposed experiments, complete description of methodologies that are applicable, and a work plan showing individual tasks and responsible institutions
-statement describing the importance of proposed project
-description of the collaborative arrangements between participating institutions defining general responsibilities and tasks assigned to each participating institution
-description of any planned workshops or symposia with clearly defined goals and expected outcomes
-explanation for the necessity of a China-Canada collaboration in order to realize the project goals (i.e. what are the unique strengths and skills that the Chinese and Canadian collaborators bring to the project).
-overall responsiveness to the criteria outlined in the RFA under the section “Peer Review Process and Evaluation Criteria”
NOTE:
*The 5 page limit does not include references, tables, charts, and figures
*If it is not possible toinsert your proposal within the application form itself, we ask that you include your proposal as an attachment formatted according to CIHR guidelines.

B3. Project Schedule and Milestones (not to exceed this page)

List the key milestones (including planned exchanges of researchers). Describe the critical steps in the realization of the project objectives and expected timeline.

B4. Biographical sketches (CV) of the Chinese Project Leaders

Include name, academic degree (title, year obtained, organization obtained) field, a list of 10 major publications of the past 5 years and a list of grants held and applied for. For Canadian Project Leaders, Common CV must be used:

Chinese Project Leaders

B5. Continuation of the collaboration (not to exceed this page)

Do you intend to continue the collaboration beyond the conception of the project? Please indicate the sources of funding, which are in place, or which you will seek, for project continuation.

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