PRIVATE AND CONFIDENTIAL
Preclinical application form
Please refer to the application guidelines for information on what to include within your research proposal. Use single-line spaced text, in Arial font, 11 point, black. Text boxes and tables can be expanded as required. Margins should be 2.5cm on all sides and total page count should not exceed 35 pages. Appendices can be used for additional supporting information where required. Please complete the accompanying budget sheet and CV template for applicants and co-applicants.
Please submit a word.doc copy to
Section 1: DETAILS1.1 Title of project
The title of the project should be succinct and should accurately reflect the content of the research.
1.2 Abstract of the project (300 words)
The abstract of the project should be laid out as follows:
· Background
· Aims
· Techniques and methodology
· Impact on breast cancer research
Please note: If your application is successful, your abstract may be published on Breast Cancer Now’s website and/or other web based directories of research. Commercially sensitive or confidential information should therefore not be included in your abstract. If, for confidentiality reasons, your abstract should not be published, please contact us.
Duration (months):
Please note that your study must start within 9 months of award.
Proposed Start Date:
1.3 Other support
Is this research supported by any other outside bodies? If yes, please provide further details. Is this application or a similar application being submitted elsewhere? If yes, please provide further details including when the outcome of the application is expected.
Section 2: APPLICANT, CO-APPLICANT AND COLLABORATORS DETAILS
2.1 Provide details of the applicants, co-applicants and collaborators.
The lead applicant and co-applicants must provide a CV using the template attached. Collaborators must provide a letter detailing their contribution to this study. Please give details of the roles of the applicant, co-investigators and collaborators on this study below.
Section 3: PRELIMINARY DATA (500 WORDS)
Please provide any preliminary data that is relevant to your application. You may also attach an additional one page document containing figures and legends relevant to your preliminary data.
Section 4: RESEARCH PROPOSAL (2500 words max)Please address the following points in your research proposal:
1) Aims and purpose of proposed investigation
Outline the objectives of the research proposal, the significance of any results that may be obtained, and their relevance to breast cancer.
2) Background to the project
Briefly outline the background to this project, as well as the need for the current proposal.
3) Plan of investigation and methodology
Detail the experimental methods, techniques and analyses that will be used to test the proposed hypotheses.
Include quantitative information on the material to be used, and its source(s)
4) Potentialrisks/challenges
Outline any potential risks or challenges you anticipate with your proposed investigation, as well as how you plan to address these.
5) Timescale
Outline the planned timescale for this investigation, including project milestones
6) Figures
An additional two page document (doc, dox, pdf) containingfigures (including legends) and a Gantt chart (or similar) may be provided.
7) References
Please provide a list of all references cited. Give full details of any references, including authors, publication, year, title, journal name, volume and page numbers. We won’t accept shortened references. References will not be included in the page count.
Research proposal (2500 words)
References
(Please add the most relevant reference for this proposal here)
Power calculations
Where applicable, please provide details about sample sizes and power calculations should be given, including as appropriate:
· The outcome measure on which the power calculations are based
· The size of the difference that the study is powered to detect, and justification of positing that size.
For population studies further details should be given, including as appropriate:
· The outcome measure on which the power calculations are based.
· The likely prevalence of the exposures of interest.
· The justification for the choice of the type I error rate.
· The justification for the effect size that the study is powered to detect.
· Details on how assumptions made about the completeness of follow-up and covariate data have been taken into account.
Section 5: COSTS
5.1 Research expenditure
Please complete the attached budget sheet and submit it along with this application form. (Please note that the first tab contains information regarding costs that will and will not be covered by Breast Cancer Now. If you are unsure of any cost requests, please contact the office at to discuss it further).
Please provide justification for each of the cost requested using the space provided below.
Salaries
Include justification for grade of staff required and any grade/scale point increases and potential increases due to inflation over the lifetime of the grant.
Minor Equipment
Materials and Consumables
Other expenses
Animal costs
Please detail the animal costs required for this research, including purchase, housing and husbandry. Please also refer to our policy on the use of animals in research.
NIHR support costs not applied for in this application
Please briefly outline support costs and AcoRD schedule B costs that will be covered by the NIHR.
Section 6: INTEGRATION WITH ONGOING RESEARCH
Describe how the proposed work integrates, but does not overlap, with the ongoing work of the research group.
6.1 Expected value (150 words)
Outline the expected value of this research to both the academic community and breast cancer patients.
Section 7: ADDITIONAL DETAILSPlease state whether this application has been submitted elsewhere, and if so when the outcome is expected by.
Intellectual property (IP) body/Technology Transfer Office
Please name and contact details of your host institution’s technology transfer office.
Patentable results
Outline if the results of this research are likely to have commercial potential. State whether there has previously been any patent filed or commercial interest expressed in the research related to this application (100 words maximum)
IP/Confidentiality Issues
Important: please state here if there are any IP, confidentiality or patient recruitment issues that would be compromised as a result of external communication of your research to our stakeholders (consider details included in your proposal as well as in this lay summary) (250 words maximum)
Ethical ApprovalIs ethical approval required for this research?
If yes has approval already been granted? / Yes No
Yes No
If ethical approval is required please state why (200 words maximum)
Research Involving Animals
If the project involves the use of animals, you must detail and justify the number and species of animal to be used; whether the animals will be genetically modified (and, if so, will these animals express, or be bred to express, harmful mutations); why an animal model is necessary and why this specific model was chosen. Please also describe how the project plan has been refined to adhere to the 3Rs by using the minimum number of animals possible and causing the least suffering (please refer to www.nc3rs.org.uk for further details).Please refer to our policy on the use of animals in scientific research here.
Please provide the following information:
- Justification for the use of the animals proposed as against any available alternative models
- Full details and justification for the numbers of animals to be used
- Details and justification for the species to be used.
- A description of the procedures to be used and action proposed to refine the techniques and whether they are described as MILD/MODERATE/SEVERE
- A brief justification on why alternatives cannot be used.
- An indication of whether you will be using genetically modified animals and, if so, whether they will be bred to express harmful mutations.
- Attach a copy of the relevant pages of the animal licence including details of the licence holder and number (if available).
Please use this section to nominate up to 5 suitable peer reviewers for your application.
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Section 8: LAY OVERVIEW (300 words)
This is a mandatory section and will be reviewed by patient advocates as part of the funding decision. It may also be used for communicating your research to a lay audience for fundraising or similar purposes should your application be successful. Please write this section for a non-scientific audience, do not use your scientific summary (300 words maximum).
Section 9: DATA SHARING PLAN (200 words)
Please describe if and how you will share the data generated by this study, other than through peer reviewed publication and presentation, to make them available to the wider research community and the public (200 words maximum). If you are not planning on sharing your data further than through publication and presentation please describe what issues or barriers are preventing you from making your data available to the wider research community.
Section 10: SIGNATORY APPROVALS
Signatures of Head of Department and Finance Office
Head of Department
I confirm that I have read this application in full and that if granted; the work will be accommodated and administered in the department/institution. All necessary licences/approvals have been or are being sought.
The institution holds/is not required to hold (*) a certificate of designation under the Animals (Scientific Procedures) Act 1986. (*) Delete as appropriateSignature of Head of Department Date:
Name and Title:
Finance Office
I confirm that the institution will administer the grant if awarded and I will ensure that the funds are used for the purpose for which they have been given.
I confirm the budget had been cost correctly in accordance with Breast Cancer Now’s guidelines.
Signature of Finance Officer
Date
Name and Title:
Address:
Telephone:
Email address:
These contact details will be used in the event of any invoicing or budgetary queries arising.
Research and Development Department (if different to Finance Office)
I confirm that I have read this application and that if granted; the work will be accommodated and administered in the department/institution.
Signature Date
Name and title:
Address:
Telephone:
Email address:
Signatures of applicants and co-applicants
Main Applicant
I have read Breast Cancer Now’s Grant Conditions & Funding Policies of award and agree to abide by them.
Signature Date
Name and title
Address:
Telephone:
Email:
Co-Applicant (please make a copy of this section for each co-applicant)
I have read Breast Cancer Now’s Grant Conditions & Funding Policies of award and agree to abide by them.
Signature Date
Name and title
Address:
Telephone:
Email:
Section 11: SUBMITTING YOUR APPLICATION
Please check that you have completed the following before submitting your application:
· All relevant sections of the application form
· Applicant and co-applicant CV
· Collaborators’ letters attached (if applicable)
· Ethical approval letters/animal license attached (if applicable)
· Institution pay scale attached
· Figures attached (where applicable)
You will need to email copies of these documents to by 4pm on 12 January 2017. The application form should be submitted in MS Word format and all other supporting documents in a relevant format, for example pdf, excel or word. Please ensure that all accompanying documents are clearly titled and dated.
If you have any queries regarding this application please contact the Research Funding Team at .
Section 11: Final Checklist
1. All relevant sections of the application form complete
2. Budget sheet complete and attached
3. Letters of collaboration attached (if applicable)
4. Ethical approval letters attached (if applicable)
5. Current institution pay scale attached
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I confirm that all requests listed above have been completed at the time of submission. I understand that Breast Cancer Now will not attach any additional information once the application is submitted. Failure to comply with the above checklist may result in the application being rejected from consideration. I understand that submission of an application indicates full acceptance of the Grant Conditions of award.
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Signature of main applicant
Version 2.0
14/12/2017