Title of the Study:
Date:
Brief Summary:
Key words:
Principal Investigator:
Title, Address,
e-mail, telephones,
Publications (separate document, to beattachedtotheresearchproject)
Collaborative Partners:
Startanddurationoftheproject:
Budget evaluation:
Total and requested funding:
Forms enclosed
(tobeattachedtotheresearch project) / ConsentForm⧠
ParticipantInformationSheet⧠
RecruitmentLetter⧠
DeclarationbyApplicant⧠
Other⧠
Signature:
■Title ofStudy:
■BriefSummaryoftheproject(200words)
■Investigators:
■Supervisor(ifstudentresearch): MailingAddress:
Email Address:
Telephone:
■Researchbackgroundandexperienceinternsofprovenexpertiseandpublications
■CollaborativePartners:
■EstimatedStartofProject:
■EstimatedCompletionofProject:
■AimandresearchobjectivesoftheResearchproject
■ConductoftheProject/ResearchMethodanddesignofthestudy
■ParticipantsasSubjectsoftheResearchProject
■Recruitment
■Potentialrisksfortheparticipants
■Requestedfundingandothersourcesoffunding
■SignificanceandBenefitsoftheResearchProject
■Forms toEnclose:
i.ConsentForm
ii.ParticipantInformationSheet(PlainEnglish)
iii.InterviewSchedule
iv.Recruitment Letter DECLARATIONBYAPPLICANTS
IsubmitthisapplicationtoEMDREuropeonthebasisthattheinformationitcontainsis
confidentialandwillbeusedbytheEMDREuropeScienceResearchCommitteeforthe
purposes of obtaining funding from EMDR Europe, and that as a consequence will be subjectedtopeerreviewandmonitoringoftheresearchprojectdescribedherein,andto satisfy reporting requirements to EMDR Europe and other related organisation, and if necessary,regulatorybodies.Theinformationwillnotbeusedforanyotherpurposewithout my priorconsent.
I declare that:
- Theinformationinthisformtogetherwithanyaccompanyinginformationis completeandcorrecttothebestofmyknowledgeandbeliefandItakefull responsibility forit.
Return Electronically to:
Benedikt Amann – Chair of the EMDR Europe Research Committee