Full Proposal Application Form

CANADA EXCELLENCE RESEARCH CHAIRS PROGRAM

PHASE 2 NOMINATION

Program Form

Nominating Institution:

Title of CERC:Canada Excellence Research Chair in

Nominee

Surname or family name:

Given name and initials:

Title or position at the time of nomination:

Department/faculty at the time of nomination:

University/organization at the time of nomination:

Country at the time of nomination:

CERCInformation

Name of the department/faculty/unit where the CERC will be located:

Expected date of appointment to the CERC://

Year Month Day

Certification Requirements and Environmental Impact

All research activities must comply with the Tri-Agency Framework: Responsible Conduct of Research, including but not limited to section 2.4 Agency Requirements for Certain Types of Research. Indicate if the research involves the following:

☐Humans subjects ☐Human pluripotent stem cells ☐Animals ☐Biohazards ☐*Environmental Assessment

*If this box has been checked, please see the Environmental impact section of the Canada Research ChairProgram’s website and follow the instructions.

Research Discipline(s) and Keywords for the CERC

Provide the most appropriate primary and secondary discipline codes from the CERC Program Discipline Codes table and up to 10 keywords that describe the chair.

Primary code:

Discipline name:

Secondary code:

Discipline name:

Keywords:

Canada Foundation for Innovation

Is a request for infrastructure support from the Canada Foundation for Innovation (CFI) included with this CERC nomination?

Yes☐No☐

Research Chair Summary

Provide a summary (maximum 150 words) of the proposed chair’s research program, written in lay language and suitable for publication. It should not be an abstract, but rather a self-contained description of the research program that will be pursued if the CERCis funded. The summary should be written in the third person and include a brief statement of objectives and approach, the intellectual merit of the program, and the broader socio-economic and/or environmental impacts targeted by the research activity.

Note:SSHRC reserves the right to edit, condense, express in plain language, etc., any content to be posted on SSHRC-managed websites.

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Funding from the CERC Program

Provide estimates on how CERC funds will be used according to the line items below. Actual expenditures may deviate from planned expenditures as long as program guidelines on the use of CERC funds are respected (consult the Chairs Administration Guide).

DIRECT COSTS / Year 1 / Year 2 / Year 3 / Year 4 / Year 5 / Year 6 / Year 7 / Total
Salary costs of incumbent
Salary and benefits of the incumbent (including any bonus paid to the incumbent)* / $ / $ / $ / $ / $ / $ / $ / $
Recruitment costs, relocation expenses, costs of teaching replacement* / $ / $ / $ / $ / $ / $ / $ / $
Student salaries and benefits
Undergraduate / $ / $ / $ / $ / $ / $ / $ / $
Master’s / $ / $ / $ / $ / $ / $ / $ / $
Doctoral / $ / $ / $ / $ / $ / $ / $ / $
Non-student salaries and benefits
Postdoctoral researchers / $ / $ / $ / $ / $ / $ / $ / $
Other (clerks, secretaries, research assistants, research associates) / $ / $ / $ / $ / $ / $ / $ / $
Other direct costs
Professional/technical services / $ / $ / $ / $ / $ / $ / $ / $
Acquisition, maintenance, operations of research equipment and other research resources (do not include funds requested from the CFI) / $ / $ / $ / $ / $ / $ / $ / $
Materials, supplies and other expenditures / $ / $ / $ / $ / $ / $ / $ / $
Travel and workshops (including field work) / $ / $ / $ / $ / $ / $ / $ / $
Other (specify): / $ / $ / $ / $ / $ / $ / $ / $
Total direct costs* / $ / $ / $ / $ / $ / $ / $ / $
INDIRECT COSTS(up to a maximum of
25 per cent of direct costs)* / $ / $ / $ / $ / $ / $ / $ / $
Total from program (maximum of
$10 million over seven years) / $ / $ / $ / $ / $ / $ / $ / $

*The salary, benefits and recruitment costs for the chairholder are not included in the percentage calculation of direct and indirect costs. For further information on what constitutes a direct and an indirect cost, consult the Chairs Administration Guide.
Funding from the Host Institution

Indicate funds and other sources committed from the host institutionto support the CERC.A minimum of 100 per cent (1:1) matching funds is required on what is requested from the CERC program. Tri-agency and CFI funding cannot count towards the required matching funds.

DIRECT COSTS / Year 1 / Year 2 / Year 3 / Year 4 / Year 5 / Year 6 / Year 7 / Total
Salary costs of incumbent
Salary and benefits of the incumbent (including any bonus paid to the incumbent) / $ / $ / $ / $ / $ / $ / $ / $
Recruitment costs, relocation expenses, costs of teaching replacement / $ / $ / $ / $ / $ / $ / $ / $
Student salaries and benefits
Undergraduate / $ / $ / $ / $ / $ / $ / $ / $
Master’s / $ / $ / $ / $ / $ / $ / $ / $
Doctoral / $ / $ / $ / $ / $ / $ / $ / $
Non-student salaries and benefits
Postdoctoral researchers / $ / $ / $ / $ / $ / $ / $ / $
Other (clerks, secretaries, research assistants, research associates) / $ / $ / $ / $ / $ / $ / $ / $
Other direct costs
Professional/technical services / $ / $ / $ / $ / $ / $ / $ / $
Acquisition, maintenance, operations of research equipment and other research resources (donotinclude funds requested from the CFI) / $ / $ / $ / $ / $ / $ / $ / $
Materials, supplies and other expenditures / $ / $ / $ / $ / $ / $ / $ / $
Travel and workshops (including field work) / $ / $ / $ / $ / $ / $ / $ / $
Other (specify): / $ / $ / $ / $ / $ / $ / $ / $
Indirectcosts / $ / $ / $ / $ / $ / $ / $ / $
Organizational investments
New programs / $ / $ / $ / $ / $ / $ / $ / $
New centre, institute, etc. / $ / $ / $ / $ / $ / $ / $ / $
Total from host institution / $ / $ / $ / $ / $ / $ / $ / $

Funding from Other Sources

Indicate funds and in-kind contributionscommittedto support the CERCfrom sources other than the program or host institution(e.g., federal government departments and agencies, provincial funding agencies, provincial and territorial departments, charities, non-governmental organizations, industry, and international organizations). Do not includetri-agency or CFI funding.

If more space is needed to enter information, add more rows to the table or attach another tableto the form.

Source of Support / Year 1 / Year 2 / Year 3 / Year 4 / Year 5 / Year 6 / Year 7 / Total
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Cash / $ / $ / $ / $ / $ / $ / $ / $
In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Total Cash / $ / $ / $ / $ / $ / $ / $ / $
Total In-Kind / $ / $ / $ / $ / $ / $ / $ / $
Total / $ / $ / $ / $ / $ / $ / $ / $

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Leveraging by Sector

For each sector listed (as applicable), provide the amount of matching funds (cash and in-kind) secured to support the CERC.Amounts in this table should align with those provided in the “Funding from Other Sources” table.

Sector / Cash / In-Kind / Total
Postsecondary Institutions in Canada / $ / $ / $
Other Canadian research organizations / $ / $ / $
Academic and research institutes abroad / $ / $ / $
Private sector in Canada / $ / $ / $
Private sector abroad / $ / $ / $
Public sector/ Government in Canada / $ / $ / $
Public sector/ Government abroad / $ / $ / $
Philanthropic/ not-for-profit/ other in Canada / $ / $ / $
Philanthropic/ not-for-profit/ other abroad / $ / $ / $
Total** / $ / $ / $

**Totals should align with those provided in the above table “Funding from Other Sources.”

Letters of reference

Each nomination must include three letters of reference.List the names and institutional affiliations of three people who will be writing letters of reference for this nomination.

Name of Referee / Institutional Affiliation
1.
2.
3.

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