Grant Application Form 2017/8
Polycystic Kidney Disease Australia (PKDA) are pleased to invite applications for the following research grants:
1 x grant up to the value of $30,000 (12 months).
1 x grant up to the value of $50,000 (over 24 months ($25,000 per annum)).
Applicants may apply for both grants if they wish, with a one year project and an extendedversion for the two-year project.
Please note that if you are applying for both grants two separate applications are required as applications will be ranked separately for each grant.
The research grants will go to two separate applicants.
Please complete all sections of the application form and email
as a PDF file to:
Please include “Grant Application Form 2018” in the email subject field.
Receipt of your grant application will be confirmed by email correspondence within 7 days.
Due Date: 30 March 2018
Please note: Grants are available to researchers in Australia only.
SECTION 1: TYPE OF GRANTBasic Research
Clinical Research
Translational Research
Genetics
Psychosocial and Public Health Research
Other (please specify) / ☐
☐
☐
☐
☐
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SECTION 2: RESEARCHER DETAILS
Principal Researcher
Title / First Name / Last Name / Qualifications & Institute Affiliations
Institution / Affiliation
Department
Address
State
Postcode
Contact No.
SECTION 3: ASSOCIATE RESEARCHER/S DETAILS
Please list all Associate Researchers who will be involved in the project
Title / First Name / Last Name / Qualifications & Institute Affiliations
Where will the project be conducted (list if multiple sites) Please include access to resources/facilities?
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SECTION 4: RESEARCH PROPOSAL4.1 Project Title:
4.2 Abstract: The abstract should include the aim and objective of the project as well as its significance to PKD (maximum 250 words)
4.3 Detailed Program Background: Please include a review of relevant literature pertaining to the project (maximum 1 page)
4.4 Research Plan: Please include sufficient detail to enable the project to be assessed in respect to ethical issues, by the appropriate ethics committee (maximum 3 pages)
Please include:
Objectives; Background; Hypothesis/ Specific Aims; Preliminary Results (where available); Proposed Method; Expected Results; Strengths and Weaknesses, Future Potential and Impact, Statistical Analysis
Note: Funding will be subject to provision of the appropriate Ethics Committee approval.
4.5 References: Please limit to five (5) key references
4.6 Ethics Committee Approvals: Funding will be subject to approval from the appropriate Ethics Committee. Does the proposed research involve trials with human subjects, animals or recombinant DNA?
☐ Yes☐ No
If yes, do you have ethics approval and will this cover the duration of the project?
☐ Yes☐ No
If you do not have ethics approval are you planning to obtain it?
☐ Yes☐ No
4.7 Plain English Summary: Please provide a summary of the project to be used in publications and other materials such as announcing successful applicants, promoting the grant, communicating with the PKD Australia network etc.
SECTION 5: FUNDING
5.1 Project Timeline
Proposed start date //
Proposed completion date //
5.2 Budget: Please provide details of how the funding will be spent.
Staff
Equipment
Consumables
Other
TOTAL
5.3 Other sources of funding for this project: Has this project received funding from other sources or have you applied for funding to other bodies?
☐ Yes☐ No
If yes, please provide details of the funding body, the amount and date funding was applied for or received:
SECTION 6: PUBLICATIONS
Please list your recent publications (past 5 years) that are relevant to this grant (give full citation).
SECTION 7: RELEVANCE
Please briefly describe how this project impacts PKD:
Thank you for taking the time to complete the PKD Australia 2017/8 Grant Application Form.
Please forward your completed application (saved in PDF format) to
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