NHMRC EQUIPMENT GRANTS 2008 – Application Form
Closing date for full applications: 4.30pm Friday 5 December 2008

1. Project Title

Provide a short descriptive title of no more than 20 words.

2. List equipment to be purchased and Dept where equipment will be located

3. Applicant Team: Chief Investigators

Chief Investigator A will be considered the contact point for the Equipment Grant and will be understood to be acting for and in concurrence with all Chief Investigators and is the investigator who takes responsibility for acceptance and conditions of award.

Chief

Investigator

/ Surname / Initials / Title / Department
A
B
C
D
E
F

4. Applicant Team: Chief Investigator details

Please complete this page for each Chief Investigator listed in Section 3

Chief Investigator

Personal details

Title
Surname
Given names

Organisation details

School/Department in Faculty of
Institution/Organisation
Postal address
Telephone
Fax
Email

Current Appointment/Position

Position title
Year appointed
Full-time/Part-time
(indicate fraction)

Research Support held for 2008

NHMRC ID Number / NHMRC Scientific Title / Position on grant eg CIA / Funds awarded for 2008
Other competitive grant support held

Funding Source

/ Project title / Position on grant eg CIA / Funds awarded for 2008

5. Proposal details

Please attach a comprehensive but brief statement
(no more than 2 pages, numbered Item 5) describing the proposal, using the following headings to structure your response:
  • The equipment should support highest quality health and medical research, as supported by the NHMRC (or other competitive grant support)
  • Lack of access to similar equipment in the institution or region
  • Collaborative gain through use of the equipment e.g. – multi-user equipment which crosses disciplines, research groups and departments.

6.Budget items
Detailed budget (written quotes must be attached) /

NHMRC ex-GST Amount Requested $

Note: Where possible, Australian-made equipment should be selected

7.Certification

Chief Investigators

The information contained in this application is true and correct to the best of my knowledge. I have read and understood the information and instructions to applicants that govern this grant and agree to have the grant administered in accordance with the relevant provisions of the current NHMRC Deed of Agreement, Version 4.

Head of Department

I support the application and certify that the equipment is appropriate to the general facilities available and that I am prepared to have the grant administered in accordance with the relevant provisions of the current NHMRC Deed of Agreement, Version 4.

Chief
Investigator / Name / Date / Signature / Signature Head of Department
A
B
C
D
E
F

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