ERA -EDTA-IMMUNONEPHROLOGY WG RESEARCH START-UP GRANT

Expression of Interest FORM

(WORD format ONLY; FONT SIZE: 12 - tables and figures must be part of the text and not sent separately but inserted at the bottom of the word page)

DO NOT CHANGE THE CHANGE FORMAT

Name of Applicant:
Surname:
Forename: /

Title & Position:

Co-Investigator(s):
Surname:
Forename:
Surname:
Forename:
Surname:
Forename: /

Title(s) & Position(s) :

/ Date of Application:
Current Address:
Postcode:
Tel:
Fax:
E-mail: / Address where research will be conducted:
Postcode:
Tel:
Fax:
E-mail:
Title of Research:
Summary of proposed research (300 words)
Summary of proposed research (continued)
Lay Title of Research (acronymous):
Lay Description of Research: (100words)
(underline 5 descriptive keywords)
Define relevance to Kidney Research in Europe with regards to Immunonephrology (300 words maximum):
Finance Requested
Year 1 Year 2 Year 3 / TOTAL REQUESTED:
Proposed Start Date: / Proposed duration (months):
Is any other body supporting research relating to this work currently?
(If YES, state organisation, support & tenure)
Please give details of any other research charities currently supporting/previously supported parts of your research programme?
Has this application been submitted elsewhere in the three months prior to submission to EDTA immunonephrology WG?
Do you intend to submit this application elsewhere in the three months following submission to EDTA immunonephrology WG?
(If YES to either please state, which organisation, & date when the decision is expected)
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Animals: Are animals in any way involved with the proposed project?
Species: …………………..
Please given a brief justification for the animal use and selected species for your proposed project:
Have you read European guidelines on the use of animals and do you confirm that you will work within these? YES / NO
Patients:
Are patients or control volunteers involved with the proposed project?
Are Human Tissues involved with the proposed application?
(If YES an Ethical Committee Letter of Approval is required and a copy of the letter must be attached to this application or dates of expected approval detailed
Tick box if attached Date expected
……...... ……
Have you read guidelines on the use of human tissues and proposals involving patients or volunteers and do you confirm that you will work within these? YES
Please state the Group’s Research Strategy (500 word maximum):
Please state the location(where the work will be carried out) Research Strategy (If separate or different from above):
DIRECTLY INCURRED COSTS
Details of Salaries
Personnel / Time Spent
on Project / Grade & Point
on salary scale / Salary
P.R / N.H.I / Super / Total for
Year 1 / Total for
Year 2 / Total for
Year 3
Hours
per
week / %
time
Salary Sub-Total

Details of Capital Equipment

Details of Consumable, Supplies

Consumables etc Sub-Total
SUB-TOTAL – DIRECTLY INCURRED Costs
(to be transferred to page 8)
DIRECTLY ALLOCATED COSTS
Details of Salaries/Costs (Part-time)
Personnel/
Expertise / Time Spent
on Project / Grade & Point
on salary scale / Salary
P.R / N.H.I / Super / Total for
Year 1 / Total for
Year 2 / Total for
Year 3
Hours
per
week / %
time
SUB-TOTAL – DIRECTLY ALLOCATED Costs
(to be transferred below)

Please list all other costs associated with the project (e.g. Principle & Co- Investigator(s) time) and who will be underwriting these.

Does the university/institute have in place systems which allow it to estimate, with reasonable accuracy, the fECs of this research? NO
Year 1 / Year 2 / Year 3
SUB-TOTAL – DIRECTLY INCURRED Costs (transferred from page 6-7)
SUB-TOTAL – DIRECTLY ALLOCATED Costs
(transferred from above)
TOTAL REQUEST (to be transferred to page 2)
Please summarise the main outcomes of the your research work/ programme(s) in the last 5 years (500 words maximum):
Please list any grants that have contributed to the above:
Grant Ref No: / Grant Holder: / Completion Date:

Total number of peer reviewed publications.
Please list (including full title, authors and journal) up to 5 that you consider key to your above achieved outcomes. You may mark any with an asterisk that are relevance to the proposed project.
PROPOSED INVESTIGATION
1.Purpose of proposed investigation (not more than 300 words).
2.Background (not more than 500 words).
3.Plan of investigation (not more than 1000 words).
  1. Indication of timescale and milestones to be achieved.
  2. Detailed justification for support requested: that the work proposed can realistically be carried out in the named establishment, and that the major expense items are essential, particularly justification of expensive salaries (not more than 500 words)
6. Short account of applicant’s previous work in this or a related field (not more than 300 words)
7.References: Please show full titles of paper(s)
8. Please indicate how the work will be followed up if the aims of the research are achieved.
NOTE: Applications in excess of the number of words requested will not be considered by the EDTA immunonephrology WG GrantsCommittee.
1.Purpose of proposed investigation (not more than 300 words).
2.Background (not more than 500 words).
3.Plan of investigation (not more than 1000 words).
4. Indication of timescale and milestones to be achieved.
5. Detailed justification for support requested: that the work proposed can realistically be carried out in the named establishment, and that the major expense items are essential, particularly justification of expensive salaries (not more than 500 words)
6. Short account of applicant’s previous work in this or a related field (not more than 300 words)
7. References : Please show full titles of paper(s)
8. Please indicate how the work will be followed up if the aims of the research are achieved.

Does the proposal have commercial potential: NO

Please list Collaborating Researchers and Institutions.
Letters from all collaborators MUST be attached confirming their agreement/involvement in the work.
BIOGRAPHICAL SKETCHES
Give the following information for EACH professional person involved on the project, beginning with the Applicant. Use continuation pages (numbered 14a, 14b etc) as necessary following the same format for each person
NAME / TITLE / DATE OF BIRTH
Place of Birth (Country) / Present Nationality / Sex
Degrees/Diplomas / Year Conferred
Research and/or professional experience (starting with present position)
Publications (List up to 5 recent publications relevant to proposed project)

1

EDTA WG Research Start-Up Grant Application

December 2009