Surname:Type HereGiven Name:Type Here

Hospital/Campus:Type Here

Title of Project: Type Here

Co-Investigator Name: / Department (if not Anesthesia):

Tab to enter additional co-investigators. Append letters of support if required.

Preliminary data/work to date

Please describe the work you have already completed on your research project. This might include specific REB approved protocols, grants, preliminary data or publications (300 words maximum).

Type Here.

Proposal

Please describe your project using the following headings Rationale, Specific Objectives, Design, Methods, Statistical Analysis, and Sample Size Estimate. Please address potential pitfalls and describe how they will be mitigated. (Maximum 1250 words).

Type Here.

Potential Impact of Project

Please describe how results will influence practice or advance your research agenda (250 words maximum)

Type Here.

Trainee Engagement

Terms of reference for uOAR grants indicate that trainees (residents, fellows, students) be included in the project. Please describe the role and responsibilities of the trainee and include a statement of deliverables.

Type Here.

Budget

Please reference institutional job descriptions, salary scales, and service rates. Append quotes for equipment purchases.

Item / Amount
1. Materials and Supplies
a. Animals (indicate type and quantity)
b. Expendables (indicate unit cost and quantity)
c. Services (indicate unit cost and quantity)
2. Equipment (detail items)
3. Personnel (indicate type, annual salary, and FTE)
Total:

Budget Justification

Justify each line item in the budget. If relevant, describe how this award will be integrated with other sources of funding (maximum 250 words).

Type here.

Previous uOAR funding

Have you received a uOAR grant in past three years?Yes  No

List any subsequent external funding applications related to your uOAR grant.

Type Here

Concurrent Funding

Please describe any previous or current applications to fund this project. Describe how these funds will be integrated with this award.

Type here.

Your CIHR Common CV

Please append an up-to-date Canadian Common CV to this application. A .pdf file of the Generic CV titled with your surname is requested.Information regarding setting up, formatting, and saving the Canadian Common CV is available on the Common CV website.

Co-investigators' CVs

Please include CVs for your co-investigators. CIHR Common CV is preferred, and attests to their research background, but we will accept whatever they can provide you.

Research Ethics Submisssion

Evidence of REB submission, or waiver of REB approval in select cases, must be included with the application form. REB approval is required before funds are released

Submission

Please compile all relevant documents into a single PDF file and email to Submission must be received by 2016-02-12

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