C.W. Young Fund Application Form

Applicants should note

  • that assessment criteria are included as guidance to completing the application form at appendix A
  • that the application must be countersigned by your academic tutor

Full name of Applicant
Registration / Training Number with the Pharmaceutical Society NI (if applicable)
Academic qualifications (with dates)
Professional qualifications (with dates)
Please confirm at which educational establishment the proposed research/ educational project is being conducted?
Please give a brief description of your current course or your relationship to theeducational establishment above
Contact details:
Correspondence Address:
Email Address:
Telephone Number (daytime)
Overview of the funding request (please review criteria)
(Information provided must not exceed 200 words, and include the title and summary of the project)
Details of funding requested
  • be specific about what element(s) of your research or project you want funded and how it relates to the overall project cost
  • see attached sheet for details of maximum award available

Justification of funding requested (please review criteria)
(Information provided must not exceed 200 words and include details on how the project outcomes are linked to the criteria)
Describing:
  • the direct benefit to the profession or healthcare setting
  • the benefit to the public

Please attach:
(i) A brief Curriculum Vitae (do not exceed 4 A4 pages).
(ii) A detailed outline of the project / research and associated course. This should, as a minimum include aims, methods to be used, ethical and governance considerations and a project timeline.
(Do not exceed 3 A4 pages, including references and any figures or tables which form part of the application).
Mail completed application to the Sarah Rice, Pharmacy Forum NI: 73, University Street BT7 1HL. Mark envelope C.W. Young Fund.
Deadline date for receipt of applications – 12pm (noon) 09 April 2018.

I the applicant have read and understand the terms and conditions appended to this application and agree to be bound by said conditions.

Signed: ______Date: ______

I the academic supervisor,verify that the information provided by the applicant is true and accurate.

Signed: ______Date: ______

Note to applicants

Please ensure that you have completed all sections of form and enclosed the required ancillary information – incomplete applications will not be considered.

Appendix A: Criteria for the assessment of applications to the CW Young Fund

Criteria
  1. Is the work relevant to pharmacy practice? NB “The income is available for the advancement and encouragement of pharmaceutical education for the public benefit”
Applicants MUST demonstrate the following:
  • Is the work relevant to pharmacy practice? (Y/N)
  • Does the work address an important area for practice? (Y/N)
  • Will the findings lead to increased knowledge or understanding? (Y/N)
  • Will the findings benefit patients/public?(Y/N)

  1. Is the study question/aim and objectives clearly stated? (Y/N)

  1. Is the work original/novel?
To help score this answer please provide the following information:
  • Has similar work has already been conducted in the past?
  • Has similar work been conducted in the past, but it was in a different setting/with a different population?

  1. Is the design of the study appropriate?
To help score this answer please provide the following information:
Would other methods give a better outcome?
  1. Previous experience
To help score this answer please consider the following:
  • Does the applicant have previous experience in the field?
  • What is the relevance of the applicants experience to the project topic?

Other important considerations that may result in the applicant being unsuccessful, regardless of their total score:
  • Academic support
    Does the applicant have academic support to facilitate the study (for example, a supervisor, library resources etc.)? If the applicant has no academic support, it may be challenging to conduct the study
  • Ethical issues
    Are there any ethical concerns with the study? If there are ethical issues, the Pharmacy Forum NI may have concerns about supporting such work. Also, the study will be unlikely to get favourable ethical opinion from an ethics committee.

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