Section on Pediatrics
American Physical Therapy Association
Planning Grant Application Cover Sheet
Title of proposed project:
Name of principal investigator:
APTA member number:
E-mail address:
Address for correspondence:
Daytime telephone number:
Names of co-investigators and their roles in the project:
Name of co-investigator:
Role:
Name of co-investigator:
Role:
Name of co-investigator:
Role:
Name of co-investigator:
Role:
Name of co-investigator:
Role:
Projected Budget:
Amount requested:
Start date:End date:
If awarded a grant, prior to distribution of funds, the PI will be required to complete a Grant Agreement Form indicating the agreed upon study period and naming an institutional grants administrator to receive the funds. Proof of an institutional approval for the protection of human subjects also must be provided.
Section on Pediatrics
American Physical Therapy Association
Planning Grant Application
Note: See Guidelines for Research and Planning Grant Applications on the Section Website before completing the application.
Title
Abstract (1 page)
Provide a 1-page summary of the proposed research and planning process.
Proposal (8 page limit)
1. Project Impact Page (1 page)
State the general research questions for the project the planning group is working toward. Highlight the rationale for this future study and its impact on pediatric physical therapy.
AND
State the objectives of the planning process.
2. Strategy (7pages or less)
This section should provide an overview of the project the planning grant is working toward developing as well as details on the planning process. The headings below are required however the page distribution is at the applicant’s discretion.
2A. Impact of the research to be planned
Summarize the rationale and impact of the study to be planned. This section should convey how the study being planned will advance pediatric physical therapy.
2B. Anticipated Approach
Describe the general approach to the research which will be completed in the future study. Extensive details are not required, however the review should have a clear understanding of the basic study design, potential outcome measures, and participants who may be included.
2C. Objective of the Planning Process
This section should clearly state the measureable objectives which will be accomplished during the 12-18 month planning period.
2D. Approach to Planning Process
Describe in detail what will be completed during the planning process. This may include but is not limited to meetings, conference call schedules, analysis of existing data, feasibility data collection, database development, and grant preparation. A time line and plan for funding submission is required.
2F. Resources
This section should highlight the personnel, qualifications to complete the planning process and future research, research environments of investigators, and may include preliminary data available for the future grant submission and/or the background of the research team which supports their contribution to the planning process.
Other Information (not counted in page limit)
1. References
List references in order of citation according to Guidelines for Instructions to Authors in Pediatric Physical Therapy. Single-space the reference list.
2. Budget and Budget Justification
Complete the budget form below and provide a strong and convincing budget justification on a separate sheet that explains clearly how costs were determined and why each expense is necessary. Funds must be requested only for essential expenses that cannot be covered by other sources. See Guidelines for Research and Planning Grant Applications on the Section Website for information about what the Section will and will not fund.
3. Appendices
Include abbreviated curriculum vitae of the principal investigator, co-investigators, and other key research team members (NIH biosketch format, 4 page max). Other appendices may include such information as preliminary data tables or figures, unusual or unpublished measurement system explanations, letters of support/collaboration, commitment of in-kind contributions.
Proposals must be e-mailed by September 1 (or by the following Monday, if the due date fallson a weekend) to be eligible for review. Send one electronic copies of the proposal to the Section on Pediatrics’ Executive Office .
If Grant Awarded: The PI will send a final report to the Grant Review Subcommittee Chair no later than 60 days following the end of the grant period. Reprints of manuscripts published from the project should be sent to the SOP. Investigators should acknowledge support from the SOP in any presentations or manuscripts.
Section on Pediatrics
American Physical Therapy Association
Planning Grant Application Budget Form
Expenses and Requested FundingCategory of Expense / Total Cost for Project / Amount Requested from SOP / Amount from Other Funding Source
Personnel
Investigators (names)
Consultants (names)
Equipment (itemize)
Supplies
Travel
Other (itemize)
TOTAL DIRECT COSTS
Updated 5/08/12