1
APPLICATION FOR RESEARCH FUNDING
to the bernese cancer league
Deadlines: 31 of Marchand 30 of September
1 original + 3copies
PROJECT
1.1.New projector continuation from the project number
1.2.title (1-3 lines)
1.3.requestedcredit (total see page 12)sFr.
1.4StartDuration (max. 18 months)
1.5.Is it likely that there will be a follow-on project ?YesNo
APPLICANT
1.6.Principal applicant
SurnameFirst name
Acad. title AHVCitizenship
Number[1]
Business address
Phone
Secr.
Fax
Home address
Phone
1.7.Co-applicant 1
SurnameFirst name
Acad. title AHV-Nr.Citizenship
Business Address
Phone
Fax
Home Address
Phone
1.8.Co-applicant 2
SurnameFirst name
Acad. title AHV-Nr. Citizenship
Business Address
Phone
Fax
Home Address
Phone
1.9.Co-applicant 3
SurnameFirst name
Acad. title AHV-Nr. Citizenship
Business address
Phone
Fax
Home address
Phone
2. / Scientific details2.1. / Summary of the research plan (max. 1 page)
2.1.1. / Addressof the ethical committee, which will be evaluating this project
2.2. / Research plan
The research plan should cover the following points:
2.2.1. / Briefdescription of the current status of research in the field in which the work is planned, giving the titles of the most important relevant studies by other authors.
2.2.2. / Brief description of the status of the applicants’s own research in the field in which the work is planned, giving the titles of the most important relevant studies.
2.2.3. / Detailedresearch plan
2.2.4. / Time frame for the whole project: Which research activities are scheduled to be carried out during the period for which funding has been requested?
2.2.5. / What in your opinion is the significance of the planned work?
How is theproposed project connected to work you are carrying out funded by other bodies (eg. university, Swiss National Foundation for Scientific Reseach, Swiss Cancer League, other cantonal cancer leagues)?
If the overall project comprises several individual projects, scientific details must be supplied separately for each of them (A,B, C). In that case, please specify which researcher(s) will be involved in each individual project and who will be the scientific project manager in each case.
2.3. / Titleandsummary of the project(for general public and non-expert readers )
If the application is approved, it will be published in the report „Swiss Cancer research“ from the Swiss Cancer League and the Swiss Cancer Research Foundation (see also The text should be written in a manner that general public and non-expert readers understand.
2.3.1. / German title (for general public and non-expert readers)
2.3.2. / English title (for general public and non-expert readers)
2.3.3. / German summary (for general public and non-expert readers)
Aim oft the project, methods, potential benefit für patients or significance für the cancer research (500-1000 characters including spaces).
2.3.4. / English summary (for general public and non-expert readers)
Aim oft the project, methods, potential benefit für patients or significance für the cancer research (500-1000 characters including spaces).
3. / Available resources
What level of funding is currently available to you; how much of this total can you use for the project under consideration (not including the funding requested in this application)?
The following details must be supplied:
3.1. / Personnel
3.2. / Existingequipment
3.3. / Existing credits for new equipment, consumables, travelling and other expenses
3.4. / Infrastructure (rooms, workshops, computercenters, librariers, etc.)
4. / Fundingrequestedfromother sources
4.1. / Funding granted from other sources (amounts, sponsors)
5. / Level of funding required
What funding will be required during the period of credit? If several projects are included in the same application, an individual budget should be given for each project separately where possible.
5.1. / Material of lasting value
Apparatus and instruments, which are commercially available, as well as components for the construction or upgrading of equipment and systems (specify manufacturer, type and supplier).
if necessary insert sheets
Total
5.2. / Consumables, maintenance und hire of apparatus
(grouped according to apparatus or system)
if necessary insert sheets
Total
5.3. / Field expenses, trips, invitations, conferences, etc. (individually justified)
if necessary insert sheets
Total
5.4. / Miscellaneous expenditures
if necessary insert sheets
Total
- Personnel requirements
6.1.Salaries
Name / Nationality / Acad. title / Function / Salary group / Gross salary paid by other sources 1st year / Gross salary paid by SCL/CRS1st year
First Name / Maritialstatus / since / % ofworking time / from / 2nd year / 2nd year
Swiss Social security number (where appropriate date of birth) / Number of children / Doctoral candidate:
Yes/No since / Salary from SCL/CRS since
1.
2.
3.
4.
5.
6.
7.
Total
6.1. / Summary of salaries
Academics
Doctoral candidates
Technical staff
Administrative staff and assistants /
No. of positions
No. of positions
No. of positions
No. of positions
/ CHF
CHF
CHF
CHF
Total / No. ofpositions / CHF
6.2. / Social security contributions (employer contributions, see information sheet on social security contributions)
Total
7.Summary
Project A / Project B / Project C / notapportionable / Total5.1. / Instruments
5.2. / Consumables
5.3. / Field expenses, etc.
5.4. / Miscellaneous
6.1. / Salaries
6.2. / Social charges
Total
Principal applicant
Place and date:
Signature:
Co-applicant 1:
Place and date:Signature:
Enclosures:
Curriculae vitae of the applicants
List of publications by the applicants
Publications number
Offers number
______
Additional page[1]Swiss Social Security Number