Wisconsin Athletic Trainer’s Association
Application for Research Grant Funds
The Wisconsin Athletic Trainers’ Association awards up to $4000 annually as grants to fund research on various sports medicine topics. Individual awards equal up to $2000 for awardees; however, additional funds may be available given adequate justification for the importance of the research study. To be eligible for this fund, you must be a certified member of the WATA, a Wisconsin state licensed athletic trainer, and employed full-time. Graduate students (in athletic training or related field) who are considered full-time students are also eligible for research grant funds. Graduate students may have the PI role; however, the application must contain faculty advisor information. Funds may be used for undergraduate research projects; however, students must be in the role of co-investigator.
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1. Primary Investigator Information
Name: Institution: Position:
Work Address:
E-Mail:
Phone:(Primary/Work): (Fax):
Certification Number: NATA Membership Number:
Have you received research assistance funds from the WATA previously? Yes No
If yes, please explain:
*Please provide a copy of the Principal Investigator’s vita/resume along with the proposal.
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2. Co-Investigator(s) or Faculty Advisor(s) Information
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Name:
Institution:
Position:
Name:
Institution:
Position:
Name:
Institution:
Position:
Name:
Institution:
Position:
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3. Project Information
Project Title:
Project Estimated Duration:mm/dd/yyyy to mm/dd/yyyy
Is this proposal being submitted to any other agency for funding? Yes No
If yes, please explain:
*Research Plan and Justification: In addition to this form, please provide a summary of the research plan and justification. This summary should be no longer than 3 pages (single spaced, 1 in margins, size 12 font, Times New Roman), not including references. Within the summary, briefly describe the following: a) short review of pertinent literature, b) purpose of the project, c) relevance to athletic training, d) research methods and procedures, e) data analysis, and f) future direction of the research project.
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4. Budget
Please itemize the research expenses below. A maximum total of $2000 is allowed. All funds requested should be essential to the completion of the proposed study and justified in the appropriate section below. Personnel costs should be itemized on an estimated per hour basis and should not include flat stipends. In addition, allocation of travel costs for presentation should be limited to $500; however, these costs should still be itemized. Institutional indirect/overhead expenses are not permissible.
a. Personnel: Subtotal $
b. Equipment & Supplies: Subtotal $
c. Travel: Subtotal $
d. Participant Payments: Subtotal $
e. Other: Subtotal $
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TOTAL $
f. Budget Justification (250 word maximum)
5. University / Institutional Assurances
Proof of compliance with Federal Regulations must be provided before funds will be released. A letter from the Intuitional Review Board (IRB) should be submitted either with the WATA research assistance funds application or following notice of an award. Please be sure the title of the project on this application and that of the IRB approved protocol are the same.
I, the Principal Investigator, agree to comply with all Federal Regulations regarding the protection of human research participants.
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6. Principal Investigator Agreement
If you receive research assistance funds, your signature below indicates that you agree to: 1)submit a written report to the WATA Research Committee, 2) present the results at a WATA Annual Meeting, 3) give permission to publish the abstract in an issue of the WATA Newsletter or WATA web site, and 4) complete the project within one calendar year of receipt of funding.
Signature: ______Date: ______
Principal Investigator
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To be completed by the WATA Research Committee:
WATA grant number: ______Review Date: ______
Research Committee Chair: ______Date: ______
WATA President: ______Date: ______
Amount Allocated: $______
Submission Information:
Submit this application via e-mail to:
David Bazett-Jones, PhD, LAT, CSCS
Chair, WATA Research Committee
Reviews by the research committee will take place biannually (April 1, November 1) and notices of acceptance or rejection will be sent to the applicant, along with feedback from the committee members, approximately 1 month following the review date.
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