/ The University of British Columbia
Office of the Vice-President Research & International /

Buchanan E163

1866 Main Mall
Email:

VPRI Research Grant for Non-Affiliated SSHRC Faculty

FOR ADMINISTRATIVE USE ONLY
ORSIL NUMBER / UBC PG (project grant)

.

IDENTIFICATION

Applicant family name

/
Given name
/

Academic Rank

Faculty

/ Department

Contact Information

Telephone
/ E-Mail
Co-investigator
Surname / First name / Department / Academic Rank
Title of Project
Key Words (list keywords that best describe your proposed research or research activity, maximum 5 words)
ETHICS CERTIFICATION
Research involving human subjects, animals or bio hazardous material require an active Certificate of Approval before funds will be released ()
Certification is required: / Certification is NOT required:
If yes please indicate:HUMAN ANIMAL BIOHAZARD ENVIRONMENT
Certificate Number:
Signatures: In signing, the applicant confirms that he/she agrees to meet the obligations of the award (e.g. reporting, use of funds, etc)
Applicant Name / Signature / Date
Department/Unit Head
Name / Signature / Date
Dean or Dean Designate
Name / Signature / Date
Research Services – UBCO Research Services to confirm entry of Application in ORSIL
Name / Signature / Date
Previous UBC Research Grant Support
Previous Grant – Project Title
Year of Previous Grant
Did you apply for external fundingYes No
If yes, what agency did you apply to and when?
Were you successful in obtaining external funding?Yes No
How did the previous grant contribute to the application for external funding?
Show how your new application is different from your previously funded project.
Budget – Attach maximum one page (10 point font) – Budget Justification
Estimated Costs / Amount / Notes
  1. Salaries

  1. Supplies and expenses

  1. Equipment

  1. Research related travel and subsistence costs

  1. Other (specify)

  1. Total

Proposed Research Project
Provide a brief description (no longer than two pages in 10 point font) of the research area, the proposed research project, and the intended activities to be carried out under the grant. Include a clear statement regarding intended applications for external funding. Descriptions exceeding the space provided will result in automatic disqualification of the application.
Application Submission
The original, signed copy of the application should be sent, by 4:00 pm on the deadline day, to:
Pam Forsberg, Grants Facilitator
Dean of Arts Office
Buchanan E163
Email:
Publication History for the Past Five Years (please attach)
Applicants should attach their publication history from the past five years including those accepted for publication and submitted for publication.
Research Grant History for the Past Five Years (please attach)
Applicants should provide a list of all research grants received over the past five years. Applicants should also include a list of all grants that have been submitted and whose competition results are not yet known.
Personal Data Form (Please attach)
Applicants must complete thePersonal Data Form found on the ORS website. Do not include a full CV.

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