The Taub Foundation Grants Program for MDS Research

2017 Full Proposal – Face Sheet

Project Period: December 15, 2017– December 14, 2020

Award Amount: $600,000 over three years, Indirect Costs up to $18,182 per year

TITLE OF PROJECT:
APPLICANT Male Female / DEPARTMENT OR DIVISION CHAIR
Name, Degree(s): / Name, Degree(s):
Full Academic Title: / Full Academic Title:
Department:
Institution: / Department:
Address: / Institution:
Address:
Telephone:
Email: / Telephone:
Country of Birth: / Email:
INSTITUTION WHERE PROJECT WILL BE CONDUCTED:
HUMAN SUBJECTS Yes No / VERTEBRATE ANIMALS Yes No
AUTHORIZED INSTITUTIONAL REPRESENTATIVE / INSTITUTIONAL OFFICER TO RECEIVE FUNDS
Name: / Name:
Institution: / Institution:
Address: / Address:
Telephone: / Telephone:
Email: / Email:
CERTIFICATION: By signing this Face Sheet, we certify that the statements contained in this Application are true and complete to the best of our knowledge, and accept the terms of The Taub Foundation Grants Program for MDS Research as documented in the Full Proposal Guidelines. The Applicant’s signature also confirms responsibility for obtaining any human subjects, animal use, and/or other required institutional approvals.
Signature of Applicant
Date: / Signature of Authorized Institutional Representative
Date:

Contact: The Medical Foundation,

Table of Contents

A) Face Sheet (template A) 1

B) Table of Contents (template B) 2

C) Project Summary (template C) 3

D) Budget (Years 1-3), Summary, and Justification (template D) 4-

E) Research Proposal (maximum of ten pages) __

·  See Guidelines for specifics

F) Biosketch (latest NIH version) __

G) Other Funding Support (Template G) __

H) Department / Division Chair’s Letter __

I) Letters of Collaboration(s) (if applicable). __

*Templates provided: hria.org/tmf/taub

Research Project Summary

The Project Summary is a 300-word scientific abstract stating the project's broad, long-term objectives and specific aims. Describe concisely the research design and methods for achieving these goals. The same Project Summary should be used for both the Online Submission and this form.

Key Words:
Project Summary: