Application and Nomination for
2017 YCCI Scholar Awards
Instructions:
· Applicants must have a full-time Yale faculty appointment at the level of Assistant Professor, Instructor or Associate Research Scientist at the time of the award and the appointment must not be contingent upon receipt of this award. Faculty who do not have an appointment as Assistant Professor must have a section of their Department Chair’s letter that describes the Department’s long-term commitment to the applicant and the applicant’s trajectory for promotion while at Yale. The trajectory for promotion must not be contingent upon receipt of this award.
· Completed applications are due at 5:00 PM on June 6, 2017.
· Applicants will be provided with a link to the website where they can complete the required form and upload the required documents either as a PDF or as a word document.
· Candidates MUST use the provided application and budget templates.
· Information collected regarding age, gender, ethnicity, race, disability and disadvantaged status will be kept confidential and is only used for anonymous reporting to the NIH.
· Applicants should follow NIH format for fonts and margins.
Application Sections
1. Abstract. Up to ½ a page. To be completed by candidate
2. For resubmissions, applicants should address the feedback about the previous application in an “Introduction” (maximum of 1 page). To be completed by candidate.
3. Candidate/Career Development Plan. The applicant should describe his/her career plans including a path to independence. The initial project should be described in context of a future research program. Maximum length is two page. To be completed by candidate.
4. Mentorship and Collaboration Plan. The applicant should describe the plan for mentorship and collaboration, including a mentorship committee that would meet periodically to review the Scholar’s research and career development should the grant be awarded. YCCI will assign an additional member to this committee. Maximum length is one page. Applicants who are requesting co-investigator support should include an extra half page to discuss how the co-investigator page will integrate into the research program. To be completed by candidate.
5. Research plan for the project to be undertaken, using the standard NIH format (Specific Aims, Background/Significance/Preliminary Data and Approach/Research Design and Methods). Maximum length is 5.5 pages. To be completed by candidate
6. References (as needed). To be completed by candidate
7. Description of all current and pending support, with amounts and dates of all external and internal sources (including start-up funds). To be completed by candidate.
8. Other Support, Departmental Administration Page. This should provide a breakdown by percentage of all current sources of support for the candidate, including all sources of funds with amounts and end dates for each external and internal source, including any start-up funds. If applicant has start-up funds, the amount and date received, and the current balance should be verified by a departmental administrator. This page is to be completed by candidate’s business office.
9. Detailed budget and justification using the included budget template. Candidates will be eligible for salary support for up to 75% professional effort (up to $100,000 including fringe) and up to $20,000 per year in research support. For candidates who are required to complete an MHS degree, the tuition cost ($7,500 in year one) must be included in the request for research support. Surgeons who are applying for salary support for less than 75% professional effort should include a statement that they need to have more than 25% professional effort devoted to direct patient care to maintain surgical skills. This section is to be completed by applicant in conjunction with the applicant’s business office.
10. Letter of support from the person making the nomination detailing the qualifications of the candidate and any mentoring arrangements that are currently in place (maximum of 2 pages). To be completed by the nominator.
11. Letters of support from the candidate’s mentors and collaborators (maximum of 1 page each). To be completed by mentors and collaborators.
12. Candidate’s NIH-formatted biosketch. To be completed by candidate.
13. NIH biosketches from the candidate’s mentors and collaborators (maximum of 5 page each). To be completed by mentors and collaborators.
14. If the nominator is not the department chair, section chief, or center director of the department in which the applicant holds a primary faculty appointment, that chair/chief/director where the applicant holds their primary faculty appointment must write a letter spelling out the department’s long-term commitment to the candidate’s development as an independent investigator (maximum of 1 page). If the nominator is the chair/director then this information should be included in the letter of support. Faculty who do not have an appointment as Assistant Professor must have a section of their department chair’s letter that describes the department’s long-term commitment to the applicant and the applicant’s trajectory for promotion while at Yale. The trajectory for promotion must not be contingent upon receipt of this award. Nominations from the Schools of Nursing or of Public Health should come from the respective Dean. To be completed by department chair/ center director (if different from part 10).
15. A signed copy of the most recent letter appointing the candidate to faculty status should be included. This should be an official offer letter and include details of the applicant’s position. This will be used for administrative purposes only.
The order of your application should be as follows:
Part 1 / Abstract/summary / Up to ½ pagePart 2 / Introduction (for resubmissions) / Up to 1 page, if needed
Part 3 / Candidate/Career Development Plan / Up to 2 pages
Part 4 / Mentorship and Collaboration Plan / Up to 1 page
Part 5 / Research Plan / Up to 5.5 pages
Part 5a / Specific Aims / Up to ½ page
Part 5b / Significance Background/Preliminary Data / Up to 2 pages
Part 5c / Approach / Up to 3 pages
Part 6 / References / As needed
Part 7 / Other Support / As needed
Part 8 / Other Support Departmental Administration / As needed
Part 9a / Detailed Budget / As needed
Part 9b / Budget Justification / Up to 2 pages
Part 10 / Letter of nomination / Up to 2 Pages
Part 11 / Letters of Support from Candidate’s mentors and collaborators / Up to 1 pages each
Part 12 / Candidate’s NIH-formatted biosketch / Up to 5 pages
Part 13 / Biosketches from Candidate’s Mentors and collaborators / Up to 5 pages each
Part 14 / Letter of support from the Chair/Dean/Chief (to be submitted directly to Nicholas Licht () / Up to 1 pages
Part 15 / A copy of the current appointment letter appointing the candidate to faculty status within the department. / As needed
Project Summary/Abstract (Limited to ½ page of text):
Resubmission Page
For resubmissions, applicants should address the feedback about the previous application in an “Introduction” (maximum of 1 page).
Candidate/Career Development Plan. The applicant should describe his or her background and training and career plans including the path to independence. Maximum length is two pages.
Mentorship and Collaboration Plan. The applicant should describe the mentorship and collaboration plan, and the mentoring committee that would meet periodically to review the Scholar’s research and career development if the grant is awarded. YCCI will assign an additional member to this committee. Maximum length is one page.
Research Plan
Specific Aims (Limited to ½ page of text):
Significance/Background/Preliminary Data (Up to 2 pages including text and graphics):
Approach/Methods (Limited to 3 pages including text and graphics):
References (As needed):
Other Support
This section should include a full description of other support, including all current and pending sources of funds with amounts and dates for each for all sources (external and internal, including any start-up funds) and any grants that are planned for submission prior to September 1, 2017. The required template can be found at: http://grants.nih.gov/grants/funding/phs398/othersupport.doc
Other Support, Continued
Must be completed by Departmental Administrator or Business Office:
Please submit a breakdown by percentage of all current sources of support for the candidate, including all sources of funds with amounts and end dates for each for all sources (external and internal, including any start-up funds). A signed copy of the current appointment letter of the candidate to faculty status within the department is also required and should be included. If applicant has any start-up funds, the amount of said funds, their date of initiation, and the current balance should be disclosed.
Name of candidate:
Breakdown of current effort:
Example:
30% - Yale-based Clinical/Patient Care
10%- VA-based Clinical/Patient Care
10%- Departmental GA funding
50%- RO1 of Robert Sherwin as an associate research scientist
Name of departmental representative completing this section:
Phone:
Email:
Signature of departmental representative:
Signature Date
Program Director/Principal Investigator (Last, First, Middle):DETAILED BUDGET FOR INITIAL BUDGET PERIOD
DIRECT COSTS ONLY
/ FROM / THROUGH09/01/17 / 08/31/2018
List PERSONNEL (Applicant organization only)
Use Cal, Acad, or Summer to Enter Months Devoted to Project
Enter Dollar Amounts Requested (omit cents) for Salary Requested and Fringe Benefits
NAME / ROLE ONPROJECT / Cal.
Mnths / Acad.
Mnths / Summer
Mnths / INST.BASE
SALARY / SALARY
REQUESTED / FRINGE
BENEFITS / TOTAL
PD/PI
SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
CONSORTIUM/CONTRACTUAL COSTS / DIRECT COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD / $
PHS 398 (Rev. 6/09) Page Form Page 4
Program Director/Principal Investigator (Last, First, Middle):DETAILED BUDGET FOR INITIAL BUDGET PERIOD
DIRECT COSTS ONLY
/ FROM / THROUGH9/01/2018 / 8/31/2019
List PERSONNEL (Applicant organization only)
Use Cal, Acad, or Summer to Enter Months Devoted to Project
Enter Dollar Amounts Requested (omit cents) for Salary Requested and Fringe Benefits
NAME / ROLE ONPROJECT / Cal.
Mnths / Acad.
Mnths / Summer
Mnths / INST.BASE
SALARY / SALARY
REQUESTED / FRINGE
BENEFITS / TOTAL
PD/PI
SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
CONSORTIUM/CONTRACTUAL COSTS / DIRECT COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD / $
PHS 398 (Rev. 6/09) Page Form Page 4
Detailed Budget and Justification
Detailed budget and justification in template word file. All candidates will be eligible for 75% of salary (up to $100,000 including fringe) and up to $20,000 of research support. Support may not be requested for a mentors or faculty collaborators. A detailed budget justification is required for all costs. If a candidate proposes sharing costs of their salary with another entity (eg, a Department or a Mentor), please outline from where the cost sharing support will come. Please use an additional page if needed.
Letter of Nomination
Letter of support from the person making the nomination, commenting on the qualifications of the candidate and any mentoring arrangements that are currently in place (maximum of 2 pages).
Letters of Support
Letter of support from candidate mentors and collaborator (limit 1 page each).
Candidate’s NIH-formatted Biosketch:
Templates and samples can be found at:
http://grants.nih.gov/grants/funding/424/SF424R-R_biosketch_VerC.docx
http://grants.nih.gov/grants/funding/424/SF424R-R_biosketchsample_VerC.docx
Additional NIH-formatted Biosketch:
NIH biosketches from mentors and collaborators (5 pages each)
Additional letter of support:
If the nominator is not the department chair, section chief, or center director of the department in which the applicant holds a primary faculty appointment, that chair/chief/director where the applicant holds their primary faculty appointment must write a letter spelling out the department’s long-term commitment to the candidate’s development as an independent investigator (maximum of 1 page). If the nominator is the chair/director then this information should be included in the letter of support. Faculty who do not have an appointment as Assistant Professor must have a section of their department chair’s letter that describes the department’s long-term commitment to the applicant and the applicant’s trajectory for promotion while at Yale. The trajectory for promotion must not be contingent upon receipt of this award. Nominations from the Schools of Nursing or of Public Health should come from the respective Dean.
Appointment Letter
A signed copy of the most recent letter appointing the candidate to faculty status should be included. This should be an official offer letter and include details of the applicant’s position.
FOT Code List