Bowel Disease

Research Foundation

APPLICATION FORM FOR RESEARCH GRANTS

Please read “BDRF and Intuitive -Robotics in Colorectal Surgery Grant Regulations2018”before completing this form.

The completed application form should be a maximum of 4 pages, including any images, and accompanied by a CV (1 side of A4) for each applicant. Please send the form and CVs electronically as a single Word or pdf document in 12pt typeface.

NB The size of boxes is only for guidance; please feel free to adjust the length of your reply to each question as appropriate to your application. You may delete this and the preceding 2 paragraphs from your completed application if you need extra space.

1. Name of the investigator who will carry out this research
2. Job title
3. Email address
4. Tel. No. (work and mobile if possible)
5. Institution
6. Name of supervisor (if applicable)
7. Name of Co-investigators
8. Name of investigator who is an ordinary member of ACPGBI
9. Title of Project
10. Brief explanation of how this project meets the application criteria
11. Length of project
12. Proposed start date (we realise that this may be subject to change)
13. Have you received any grants from BDRF before?

Funding requested

14. Total amount
15. Breakdown of costs
16. How many instalments (where applicable)
17. In which months instalments are to be paid (where applicable)
18. Justification of support requested(Explain why each item of expenditure is needed)
19. Has the institution administering
Funding, agreed exemption from overheads? / Yes No
20. Intuitive Product used in research project

Project Details

21. Background to project

22. Methodology

23. References (if any): Maximum of 4

24. Sample size and source of statistical advice (if appropriate)
25. Have you applied for or acquired funding from any other source(s) to support this work? / Yes No
If Yes, where?

Lay summary

26. Please supplya 200-300 word summary of the project expressed in lay terms (for information to the public if the grant is awarded)

a)Problem addressed, background and strategic significance

b)Method(s) used

c)Hoped for results of this research

d)What further plans are proposed for future development?

27. For each applicant and co-applicant, please attach to this application form a one-page CV which should include their 4 most recent publications.

Bowel Disease Research Foundation & Intuitive - Robotics in Colorectal Surgery Grant Application form 2018