/ The Chairperson
Scientific Advisory Panel of the PRF
C/O the National Institute for Communicable Diseases
Private Bag X4
Sandringham
2131
MAJOR IMPACT PROJECT APPLICATION
Closing dates: 28 February of each year
Please note the following:
  • Research grants are awarded to establish researchers who have a track record of independent innovative research supported by a significant publication record
  • This grant will only be awarded to applicants in possession of at least a PhD or equivalent degree
  • The funding ceiling is R 500 000 per annum for 3 years. A small number of Major Impact grants will be awarded each year for outstanding grant applications which have high impact value. Full and detailed motivation will be required as well as information proving merit and high impact of the project
  • The PRF must be acknowledged in all publications arising from a proposal funded by the PRF.
  • The deadlines for submission of applications must strictly be adhered to. Applications must arrive at the NICD on or before the deadline date. No late applications will be considered
  • Ensure that all sections of the form are completed and all requested information attached.
  • Application forms must be typed. No hand written applications will be accepted. Please format the document carefully and number all pages
  • E mail complete and signed application to:

GENERAL INFORMATION
Surname
Name
Title
Race
Gender
Citizenship / South African citizen / YES / NO
Other (Please provide detail)
Present Institution
Work Address (FULL postal address)
Telephone
E-Mail
Institution name for relevant grant cheque
Bank detail of relevant institution
Qualifications
Present Professional Status
RELEVANT WORK EXPERIENCE TO DATE
Name of employer/Institution / Capacity and type of work / Period
PLEASE ATTACH TWO-PAGE CV
PROJECT INFORMATION
This section should include information relating to:
− The purpose of the research
− The importance of the research
− The background and feasibility of your project
− A brief description of relevant information, the target population, hypotheses, and methodology
− A brief description of methodology and expected results
− A description of the contributions your research will make to the field of knowledge and health outcomes.
TITLE OF PROJECT
SCOPE OF THE PROJECT FOR WHICH A GRANT IS REQUESTED (PROPOSED RESEARCH PROGRAM AND PLAN OF APPROACH)
Specific Objectives
Preliminary Data
Research plan and methodology
Timelines
BRIEF REVIEW OF PUBLISHED LITERATURE AND RATIONAL TO PROPOSED PROGRAM (MAX 10 REFERENCES)
As a general rule, citations older than 10 years should not be used unless they are absolutely necessary in making the case for the proposed study or, if they are seminal works that should not be omitted.
DETAILS OF RESEARCH TEAM
Note: Please attach a SHORT CV of Supervisor and Senior Members of the Research Team
Name / Qualifications / Role / Time devoted to Program
BUDGET DETAILS (PLEASE ENSURE THAT UNIT COSTS AND NUMBER OF UNITS ARE SPECIFIED)
Consumable Materials / Number of Units / Unit Cost / Year 1:
201... / Year 2:
201... / Year 3:
201...
Total
OTHER (SPECIFY)
Description / Qty / Price per Unit / Total
Total
CAPITAL EQUIPMENT (ITEMS EXPECTED TO LAST LONGER THAN THREE YEARS)
PLEASE ATTACH QUOTATIONS
Description / Cost (VAT Inclusive)
Total
Motivation for Purchase of Equipment
BUDGET SUMMARY
1st Year / 2nd Year / 3rd year
Consumables
Other
Capital Equipment
Total
DECLARATION OF RESEARCH FUNDING
Is this your first application to the PRF for a grant?
If no , please supply details
Details of all other research funding received at present
Name of Organisation / Project title (Short) / Amount / Duration / Role in project / Time spent on project
Does this present application overlap/partial overlap any of your funding received? / Yes / No
If YES-justification overlapping:
NB: Any omission or misrepresentation in this section could jeopardize this and future funding
Apart from your university/institution, are any other institutions concerned with the provision of facilities (which may include clinical material) necessary for this research project? If yes, complete the table below
Name of university/institution / Facilities required/provided
ETHICS COMMITTEE CERTIFICATE (Has this application passed through the Ethics Committee?)
NB: Your application will not be considered unless relevant ethics approval has been accepted
Human / Animal
Approved (Please provide certification and number)
Pending
Not Applicable
CHECKLIST: PLEASE COMPLETE/ATTACH
CV (including publications) / Yes (attached) / No
Quotes for equipment / Yes (attached) / No
Application signed? / Yes / No
All information complete and document properly formatted? / Yes / No
Application approved by Research Committee? / Yes / No
Application E-mailed to: ? / Yes / No
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION, ATTACHMENTS AND CORRESPONDENCE ARE CORRECT AND THAT, IF I AM GIVEN A GRANT, I WILL ABIDE BY THE REGULATIONS GOVERNING THE AWARDING OF GRANTS
APPLICANT
Print Full name and surname
Date
Signature
ARE YOU WILLING TO REVIEW PRF GRANT APPLICATIONS? / YES / NO
RECOMMENDATION BY THE RESEARCH COMMITTEE OF THE PARTICULAR INSTITUTION
Recommendation: Approved/not Approved
Print full name and surname
Date
Status/capacity of representative of institution concerned
Signature