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APPLICATION FOR A RESEARCH PROJECT GRANT

Please type throughout in Arial font point size 11.Please submit the signed originaltogether with the detailed project report andan electronic copy on stick or by email.

Title of research project:
Date of Application:
Name of Applicant: /

Title & Position:

Co-Investigator(s):
(1):
(2):
(3): /

Title(s) & Position(s):

Address where research will be conducted:
Address:
Postcode:
Tel:
Fax:
E-mail:
Full Lay Ddescription of research:
Financial:
Total amount applied for £______. See page 5 for detailed breakdown.
Proposed Start Date: / Proposed duration (years/months):
Is any other body currentlysupporting research relating to this work? YES/NO
(If YES, state organisation, level of support & tenure)
Please give details of any other charities which currently supporting or have previously supported the relevant parts of your research programme?
Has this application been submitted elsewhere in the three months prior to submission to Mersey Kidney First? YES/NO
Do you intend to submit this application elsewhere in the three months following submission to Mersey Kidney First? YES/NO
(If YES to either please state, which organisation, & date when the decision is expected)
Is this application a resubmission of a previous application submitted to
Mersey Kidney First in the last twelve months? YES/NO
(If yes please give details when it was last considered, reference number and also complete the box immediately below)
Please give full details of how this resubmitted application is different from the previously submitted application.
Is this application a continuation of research previously funded research by
Mersey Kidney FirstYES/NO
If Yes please provide name and reference number of the previous project
AnimalsAnimal research: Are Is there any work on animals in any way involved within the proposed project? YES/NO
Please give details:……………………..
Species: …………………..
PatientsHuman Research:
Is there any work on Are patients or control healthy volunteers involved within the proposed project? YES/NO
Is there any work on Are hHuman Tissues tissues involved in the proposed projectwith the proposed application? YES/NO
Please give details:……………………..
Havesall applicable Ethical ethical and governance approvals been granted for this?YES/NO
Please give details:……………………..
Research student:
Will a postgraduate research (PGR) student be working on this proposed project? YES/NO
Please give details of
  • The proposed PGR programme (e.g. MD/PhD/MPhil, FT/PT, department/institute)
  • How the student will be sought and selected
  • What training opportunities the project will provide
  • The proposed supervisory team

FINANICAL FINANCIAL INFORMATION
Total
for
Year 1 / Total
for
Year 2 / Total
for
Year 3 / Overall
Project
Total
Research salaries
Student stipend/fees (Please detail)
Consumables
Equipment
(Please detail)
Other costs
(Please detail)
Totals
Notes:
Please sign Original in ink. Per Pro signatures are not acceptable.
Applications submitted without the following signatures will not be considered.
The following declarations must be completed
Applicant (s):
I have read Mersey Kidney First’s terms and conditions and, if my application is successful, I agree to abide by them. I shall be actively engaged in, and in day-to-day control of the project.
Signature of Applicant: ……………………………. Date: ………………..……………….
Signature of 1st Co-Investigator: ………………… Date: ……………………………..….
Signature of 2nd Co-Investigator: ……………….. Date: ………………………………...
Signature of 3rd Co-Investigator: ………………… Date: ………………………………...

Official Authorised to Sign for

Mersey Kidney First (on approval)

Name:
Title: / Signature: ……………………………………….
Date: ……………………………………………..

RESEARCH PROJECTS – NOTES FOR APPLICANTS

  1. Applications for financial assistance will not be considered without a completed and signed official application form.
  2. The financial support requested within a research application is the absolute amount that will be funded under the terms of the project. It is therefore in the applicant’s interest to ensure that costs are accurate and that all costs required are included. If it is anticipated that amounts in excess of the original agreed funding are required to complete the project, then the applicant should seek to submit a revised project application as early as possible.
  3. Applicants should ensure that salary costs include all associated on-costs including employers’ national insurance and superannuation, and reflect increments and movements in salary over the duration of the project.
  4. Should failure to seek additional funding result in the project being incomplete at the end of its duration, then this would jeopardise any future funding being awarded to the applicant by the charity.
  5. An under-spend on a project is not available to be carried forward to a future project in any circumstances.
  6. Expenditure incurred on a particular project should be charged to that project. The virement of costs (particularly consumables) between different projects is not permitted under any circumstances and may be regarded as fraud by the charity. In such cases appropriate action will be taken.
  7. Any significant amendments to the project including changes to the individuals involved, the timing or duration of the project, or the nature of the research should be notified to the charity’s offices immediately. Failure to do so could result in funding being withdrawn.
  8. Applicants are expected to adhere to the full terms and conditions if funding is approved.
  9. Where testing or monitoringworkof on animals,or humans form or human tissue forms part of the research, the applicant is expected to have obtained all applicable ethical consents and governance approvals prior to the commencement of the project.
  10. In considering project applications, the decision of the charity’s trustees is final and there is no right of appeal. However applicants may resubmit a project application at any time.

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Research Project Grant Application

August 2015June 2016