PROJECT GRANTS
ABSTRACT APPLICATION FORM /

The layout of the form must NOT be altered relative to the original. The form should be filled in using Arial font, size 12, single spacing. Applications not abiding by the guidelines will automatically berejected. The completed abstract application form should be returned by email to by 5pm onMonday 2November2015. Applications received after this time will not be considered.

1. APPLICANT

Title:Surname:Forename(s):

Post(s) currently held:

Address:

Telephone work:Mobile:Email:

2. CO-APPLICANT(please refer to guidelines)

Title:Surname:Forename(s):

Post(s) currently held:

Email:

3. COLLABORATORS (please refer to guidelines)

a.

b.

4. TITLE OF PROJECT

Proposed Start Date:Proposed Duration (months):

5. RESEARCH PRIORITY AREA

ConsultFight for Sight’s Research Strategy 2012-2017 and indicate which ONE of thesix research priority areas (pages 8-11) you would like your application to be considered under.

6. SIGHT LOSS AND VISION PSPCATEGORY AND PRIORITY

Consult the Sight Loss and Vision Priority Setting Partnership website and indicate which of the 12 eye disease/condition categories your application addresses as well as which priority number(s), within the category, it focuses on (please refer toguidelines).

  1. Age Related Macular Degeneration (AMD)
/ Priority number:
  1. Cataract
/ Priority number:
  1. Childhood Onset Disorders
/ Priority number:
  1. Corneal and External Eye Conditions
/ Priority number:
  1. Glaucoma
/ Priority number:
  1. Inherited Retinal Diseases
/ Priority number:
  1. Neuro-ophthalmology
/ Priority number:
  1. Ocular Cancer
/ Priority number:
  1. Ocular Inflammatory Diseases
/ Priority number:
  1. Refractive Error and Ocular Motility
/ Priority number:
  1. Retinal Vascular Diseases
/ Priority number:
  1. Vitreoretinal/Ocular Trauma
/ Priority number:

7.DESCRIPTION OF PROPOSED PROJECT (Follow the headings given,maximum 2 sides of A4)

  1. Aims of the research
  1. Background (work that led up to the project, including relevant references asper guidelines)
  1. Detail any overlap with existing grants from any source
  1. Plan of investigation, methods and techniques
  1. Importance of research and expected outcomes

8. REVIEWERS

Please suggest names of three external reviewersto peer review the full grant application including departments, institutionsand email addresses. Of these, at least one and preferably two should be outside the UK. We may send your application to other reviewers of our choice.

a.

b.

c.

9. SIGNATURE OF PRINCIPAL APPLICANT

I will be responsible for the day-to-day supervision of the research. My contract in the Host Institution lasts at least as long as the duration of the project grant. I have read Fight for Sight’s Terms and Conditions and agree to abide by them.

Signature:Date:

Note: Fight for Sight’s Terms and Conditions have been revised.

Note: Please complete the CV sections below (section 10principal applicant, section 11co-applicant(s)).

10. CURRICULUM VITAE OF PRINCIPAL APPLICANT(maximum 2 sides of A4)

Title:Surname:Forename(s):

Post(s) currently held:

Date of Appointment(s):Expected date of Termination(s):

With whom do you have your current contract of employment?

What will be your time contribution to this project per week?

Academic and Higher Qualifications:(subject, class, university, date, most recent first)

Previous three posts held:(with dates, most recent first)

Recent publications:Maximum 10,relevant to the project, in chronological order, the most recent first. Please give citations in full (please refer to guidelines).

Grant support:Please list grants held in the past five years, most recent first including the title of project, amount awarded, duration of grant and funding body. For current grants, indicate the number of hours per week that are spent on each project.

11. CURRICULUM VITAE OF CO-APPLICANT (maximum 2 sides of A4)

Title:Surname:Forename(s):

Post(s) currently held:

Date of Appointment(s):Expected date of Termination(s):

With whom do you have your current contract of employment?

What will be your time contribution to this project per week?

Academic and Higher Qualifications: (subject, class, university, date, most recent first)

Previous three posts held: (with dates, most recent first)

Recent publications: Maximum 10, relevant to the project, in chronological order, the most recent first. Please give citations in full (please refer to guidelines).

Grant support:Please list grants held in the past five years, most recent first including the title of project, amount awarded, duration of grant and funding body. For current grants, indicate the number of hours per week that are spent on each project.

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