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Research Programme Application (PA216)
Module 1 of the application must be completed on the HRC Gateway to register the application and receive an HRC Ref ID#. This form contains a Coversheet, Modules 2, Module 3 and Sections 4A-4D of Module 4. The contract information and/or budget file for Module 4E-H must be uploaded separately. Module 5 contains NI CVs that are uploaded separately. Module 6 is the research classification of the research that must be completed online. Module 7 references parts of the administrative agreement for successful applicants with no input required in this application.
This form must be downloaded and completed by applicants before being uploaded to the HRC Gateway as a pdf file. The complete application with all Modules will be generated by the HRC Gateway for downloading and printing.
COVERSHEET
HRC Ref ID#:Click here to enter HRC Ref ID#
NI:Click here to enter surname
Research Investment Stream:Click here to enter RIS
Computer used to complete this form:Click here to enter Windows or Mac.
This page is for identification purposes only. It will be replaced by the online pages in the final system generated application.
Enter the details above before going to the next Section.
In the pdf version of this document Module 2 must begin on a new page.
Hints for adding content to forms
This form was developed in MS Office 2013.
Form fields have Arial 10-point font as default although bold and underlined variations are acceptable.
Develop draft information in a separate document and then copy into this form. The draft should use Arial 10-point font to avoid formatting problems that may cause problems.
Referencing with Endnote may not function in this form in which case copy Endnote lists as text only.
The CV must be in Arial 12-point font.
PA216 Form ©2015 Health Research Council of New Zealand. All rights reserved. Coversheet: 1
IN CONFIDENCE
MODULE 2: RESEARCH
Section 2A – Summary of Research Programme (one page)
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Rationale for Research
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Aims
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Research Design and Methods
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Research Impact
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Section 2B – List of Proposed Research Objectives
List the proposed research objectives or projects within the Programme and the Named Investigators leading these parts of the Programme.
Objective or Project Title(80 Characters maximum) / Leading Named Investigator
(Surname, Initial)
Section 2C – Description of Proposed Research Programme (15 pages maximum)
1. Describe the research objectives or projects and how they form a cohesive theme of research (use diagrams as appropriate). For each component, the rationale, design & methods, impact against Investment Signal goals, and research team track record should be covered.
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2. The long-term goals of the research group as they relate to the HRC Research Investment Streams and Signal goals.
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3. The collaborative nature of the research. Collaboration with other research groups, both nationally and internationally, and if appropriate, liaison with health services providers and the health policy development process.
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4. The staffing, management and organisation of the research programme, including administrative mechanisms, resource and financial management.
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5. The training opportunities for young investigators that exist or will be developed within the programme.
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6. The level of support and facilities provided by the host organisation.
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7. The research group’s productivity and likely impact on improving human health.
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8. The group’s policies and practices for the dissemination of research results.
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9. The research group’s policies and general activities with respect to responsiveness to Maori as it relates to health and/or health research.
How might your research contribute to the health needs of Māori? What is the health significance and context of this research to Māori? Discuss the incidence or prevalence in Māori, or indicate if not known to be significantly different from the general population. Have you sought advice for the study from a Māori researcher/representative (if applicable)?
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MODULE 3: REFERENCES
Click here to enter text. There is no limit to the number of reference pages. Asterisks are to be placed beside applicants’ publications. Provide references in full and state full authorship (for example not Smith et al). Endnote lists should be copied into a plain text editor before pasting in here.
MODULE 4: CONTRACT INFORMATION AND BUDGET
Section 4A – Justification of Expenses
Justification of Research Staff (as listed in budget)
Click here to enter text. Justify the role of all staff (named and unnamed). Unnamed postdoctoral fellows should also be justified here, but unnamed PhD students will be disallowed. “Staff” may include research assistants, technicians, medical staff, interviewers, support staff or similar, whose names or position titles are listed in the budget under “Research Staff” and who have specific FTE involvements. Clearly state if staff will be promoted during the Programme, or the annual salary inflation will automatically be capped to 3%.
Justification of Working Expenses and Casual Staff (as listed in budget)
Click here to enter text. All items listed under Materials and Research Expenses in the budget should be justified, with costs broken down per item unit, and full costs per item for number of units requested.
Section 4B – Previous / Current Contracts and Awards
List Previous / Current Contracts awarded within the past 5 years.
Funding agencyTitle of research
Investigators
Start date and duration
Total value
Nature of support (1 sentence)
If HRC contract (HRC Ref #), are all final or annual due reports filed? Reason if due report not submitted?*
*Delayed submission without justification will result not only in contract suspension but also in disqualification of new research applications.
Click here to paste in as many copies of the above table as required, or replace the table with a spreadsheet using the same layout
Previous HRC Final End of Grant Report(s)
List here and upload the pdf version of all previous HRC final end of grant reports (from the Annual Funding Round and Research Partnership contracts) from the past 5 years (for senior Named Investigators) using the HRC Gateway.
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Section 4C – Other Support
Project Applications Related to this Proposal
Yes / NoAre any named investigators on this programme also named investigators on a project application? (Y/N)
If yes, is the project a component of this programme application such that the Project will be considered withdrawn if the Programme is fully funded? (Y/N). Provide HRC Ref #
If no, then in the area below identify the Project, briefly outline its area of research and clearly explain how your Programme is separate from it.
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Other Research Applications Awaiting Decision
Applicants must advise the HRC of the outcome of other research applications through their Research Office.
Funding agencyTitle of research
Investigators
Start date and duration
Total value
Date of outcome
Areas of overlap with this Application. HRC Ref #?
Funding agency
Title of research
Investigators
Start date and duration
Total value
Date of outcome
Areas of overlap with this Application. HRC Ref #?
Click here to paste in as many copies of the above table as required.
Co-Funding
What other agencies or end-users have been approached or committed to joint or partial funding of this research?
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Financial Interest(s)
Do you or any named investigator have a financial interest related to the research or sponsorship of the research?
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If yes, outline below and provide details of your conflict management strategy.
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Section 4D – Letters of Collaboration/Supporting Documents List
List all memoranda of understanding or subcontracts, letters of collaboration (which outline material or actual support) and supporting budget documents. Refer to the Guidelines for instructions about how to attach these documents.
Referees and Science Assessing Committee members will see the list below and documents will only be made available on request.
Note that Appendices are not permitted.
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List of Collaborators (National and International)
Please list all collaborators (not Named Investigators) associated with this project
Collaborator Name / Organisation / Country / Purpose / Support (NZ$ or in-kind)Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
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Section 4E – 4H Contract Information
Upload the HRC Excel file ‘HRC216budget.xlsx’ containing Sections 4E-4H to the HRC Gateway. Note that a pdf version of the file is also required.
PA216 Form ©2015 Health Research Council of New Zealand. All rights reserved. Module 2-7: 1
IN CONFIDENCE