Voelcker Fund Young Investigator Award on Translational Science

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Principal Investigator

Voelcker Fund Young Investigator Award on Basic and Translational Science

Step 2 Full Proposal Application Form

Send your complete application package (see page 2) to:

Emily Harrison Liljenwall, Max and Minnie Tomerlin Voelcker Fund,

112 E. Pecan, 30th floor, San Antonio, TX 78205

Complete application packages must be received by February 23, 2018 4:00pm CST.

Project Title: (Maximum 75 characters)

Disease Area: (choose one or more areas from the Disease of interest to the Voelcker Fund i.e. cancer, heart disease, arthritis, muscular dystrophy, retinitis and/or macular degeneration of the retina)

Principal Investigator: Full Name, Degree(s):

Current Appointment Title (e.g., Instructor, Assistant Professor):

Additional Current Job Title(s) (if any):

Institution:

Department:

Street Address:

City, State, Zip Code:

Telephone: Fax: E-mail:

Completion Date of Most Recent Fellowship:

First Faculty-level Appointment Title (e.g., Instructor or Assistant Professor):

First Faculty-level Appointment Date: Institution:

All full-time post-fellowship Instructor-level positions will be considered full-time faculty-level appointments.

Citizen of what country:

Permanent resident of what country-documentation must be provided:

Signature______Date Submitted______

TENURE INFORMATION:

Does your institution offer tenure?

If yes, are you on the tenure-track?

If yes, do you have tenure?

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Principal Investigator

GRANTS AND CONTRACTS OFFICIAL TO NOTIFY IF AWARDED:

Full Name:

Institution Name:

Title:

Department:

Street Address:

City, State, Zip Code:

Telephone: Fax: E-mail:

Initial to acknowledge that the investigator has a full-time faculty-level appointment at your institution.

Signature Date Submitted

MENTOR INFORMATION:

Provide the following information for the mentor(s) who have submitted a letter of recommendation as part of this application package. Do NOT include information on mentors who have not submitted a letter.

Mentor 1:

Full Name, Degree

Title(s):

Institution:

Department:

Mentor 2:

Full Name, Degree

Title(s):

Institution:

Department:

FORMATTING INSTRUCTIONS

Font: Use 12-point font size throughout unless noted otherwise. Smaller font sizes are acceptable for use in tables and figure legends.

Page Margins: Page margins should not be smaller than one inch on all sides, subject to preset format.

Page Limits: Do not exceed the pages limits stated for each section.

Appendices: Do not attach any additional materials except as allowed.

Proposals that do not meet the page limits (including letters) and formatting instructions will not be accepted. Nominees not adhering to the instructions will not be notified or given a chance to revise their submission, so it is very important to follow the instructions above.

A COMPLETE APPLICATION PACKAGE CONTAINS:

1 signed original of the complete application; and
CD-ROM containing a single Portable Document Format (PDF) fileof the entire application.

**Applicants are strongly encouraged to review their final PDF file prior to submission. It is the applicant's responsibility to ensure that all materials to be included in the application have been properly converted and inserted into the PDF file.

If you have questions, please read the Frequently Asked Questions at If your question is not answered there, please send an email to with "2018Young Investigator" in the subject line.

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Principal Investigator

Face Pages...... 1-2

Table of Contents Page ...... 3

Part 1: Proposal

Abstract (Maximum l/2 page) ...... 3

Acronym List (Maximum 1 page) ......

Biographical Sketch (Maximum 2 pages)

Provide three peer reviewed reprints either published or in press ......

Career Goals and Objective (Maximum 1 page) ......

Research Plan (Maximum 9 pages including figures, excluding literature cited) ......

Literature Cited ......

Budget Year l......

Summary Budget and Budget Justification......

Description of Resources (Maximum l page) ......

Other Sources of Research Support ......

Consultant/Collaborative/Contractual Arrangements (if applicable) ......

Part II: Institutional Support Documents

Environmental and Institutional Commitment Letter (Maximum 2 page letter) ......

Letter of Support from Mentor (Maximum 2 page letter) ......

Supporting Materials Template......

Abstract (Maximum 1/2 page)

State the broad, long-term objectives and specific aims. Describe concisely the research design and methods for achieving these goals. If the application is funded, this description may become public information.

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Principal Investigator

Acronym List (Maximum 1 page)

Provide a complete list of acronyms used in this proposal and their definitions.

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Principal Investigator

Biographical Sketch (Maximum 2 pages; do not attach reprints. Use 10-point font.)

NAME: POSITION TITLE:

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EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, and include postdoctoral training.)

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INSTITUTION AND LOCATION DEGREE YEAR(s)FIELD OF STUDY

(if applicable)

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A.Positions and Honors. List in chronological order previous positions, concluding with your present position.

List any honors. Include present membership on any Federal Government public advisory committee.

B.Peer-reviewed publications (in chronological order). Provide complete references to peer-reviewed publications only; highlight first author (or equivalent) publications. Do not include publications submitted or in preparation, abstracts, or case studies.

C.Reprints. In addition, provide three peer reviewed reprints either in press or published (no manuscripts in preparation).

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Principal Investigator

Career Goals and Objectives (Maximum 1 page)

Describe your career goals and objectives with particular emphasis on the relationship to clinical/translational research. Indicate how your past scientific history relates to these goals and objectives. Indicate how a Voelcker Fund Young Investigator Translational Development Award would facilitate achievement of your goals. If your interest in clinical/translational research is a change in direction, please describe what prompted the change.

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Principal Investigator

Research Plan (Maximum 9 pages including figures, excluding literature cited.)

The research plan must have the following sections:

Hypotheses and Specific Aims. State the hypotheses that form the bases for the research and the specific aims that you intend to accomplish with the award.
Background and Significance. Discuss the scientific knowledge that led to the stated hypotheses and specific aims and cite critical references. State the importance and health relevance of the proposed research.
Preliminary Results. Present data pertinent to the proposed research, especially if they substantiate the validity of a new technique or hypothesis or demonstrate expertise in a new area of research.
Research Design and Methods. Describe the procedures and methodology that will be used to accomplish the specific aims of the project. Discuss any potential difficulties and alternate approaches that might be taken to accomplish the goals.
Time Frame. Provide estimated milestones for accomplishing key goals.

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Principal Investigator

Literature Cited in Research (No page limit; use 10-point font.) Provide complete references with titles to literature cited in the body of the research plan.

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Principal Investigator

BUDGET YEAR 1: The investigator must devote at least 50% effort to translational research throughout the duration of the award. Although salary support is not required, the investigator and his/her percent effort must be listed.

Personnel (Name/Job Title)%Effort%SalarySalaryFringeSubtotal

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

4. %% $ $ $

Year 1. Personnel Total: $

Consultants (Name/Job Title)

1. %% $ $ $

2. %% $ $ $

Year 1. Consultants Total: $

Equipment

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

4. %% $ $ $

Year 1. Equipment Total: $

Supplies

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

4. %% $ $ $

Year 1. Supplies Total: $

Patient Costs

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

4. %% $ $ $

Year 1. Patient Costs Total: $

Travel

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

4. %% $ $ $

Year 1. Travel Total: $

Other Expenses

1. %% $ $ $

2. %% $ $ $

3. %% $ $ $

Year 1. Other Expenses Total: $

TOTAL DIRECT COSTS:$

TOTAL INDIRECT COSTS:$

TOTAL YEAR 1:$

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Principal Investigator

Summary Budget

In the table below, provide summary budget information about how the award will be spent. The total duration of the award will not exceed 3 years. The budget for each year cannot exceed $150,000 in total costs. Indirect costs cannot exceed 10%. Travel costs cannot exceed $3,000 per year.

Total Budget

Year 1 / Year 2 / Year 3 / Total (10%)
Personnel
Consultants
Equipment
Supplies
Patient Costs
Travel
Other
Direct Costs
Indirect Costs

Total

Budget Justification Include a short explanation of any exceptions to the investigator's time spent on the grant, large or unusual budget allocations and other expenses that may not be self-evident. Do not provide justification of the entire budget. (Maximum 1/2 page)

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Principal Investigator

Description of Resources (Maximum 1 page)

Specify the general laboratory/office facilities at your disposal. Indicate the specialized equipment and facilities required for your research and their availability. Describe facilities for patient studies if needed, such as hospital units or clinical research centers.

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Principal Investigator

Other Sources of Research Support

List ALL current and pending internal and external sources of funding for the principal investigator. The following FORMAT must be followed. Be sure to fully explain any potential funding overlap.

Current or Pending Funding?
Project Name
Award Type and Number
Funding Agency/Institution
Principal Investigator
Your Role on the Project and Percent Effort
Annual Direct Costs
Total Award (Direct and Indirect)
Project Period (start and end dates)
Brief Project Description
Indicate if the project is related to the work proposed
Indicate the project’s relationship to the work proposed in this application
Current or Pending Funding?
Project Name
Award Type and Number
Funding Agency/Institution
Principal Investigator
Your Role on the Project and Percent Effort
Annual Direct Costs
Total Award (Direct and Indirect)
Project Period (start and end dates)
Brief Project Description
Indicate if the project is related to the work proposed
Indicate the project’s relationship to the work proposed in this application
Current or Pending Funding?
Project Name
Award Type and Number
Funding Agency/Institution
Principal Investigator
Your Role on the Project and Percent Effort
Annual Direct Costs
Total Award (Direct and Indirect)
Project Period (start and end dates)
Brief Project Description
Indicate if the project is related to the work proposed
Indicate the project’s relationship to the work proposed in this application

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Principal Investigator

Consultant/Collaborative/Contractual Arrangements (Each letter maximum 1 page)

If applicable, include letters verifying any consulting, collaborative, or contractual arrangements necessary to conduct the proposed research. On this page, indicate in a list format, the attached letters. Note: Do not use these letters as the recommendations letters required in the following sections.

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Principal Investigator

Environment and Institutional Commitment (Maximum 2 pages)

Replace this page with a letter signed by the department chairperson* that must outline the following:

the commitment the institution has made to enable the applicant to conduct translational/clinical research, including any provision for formal training in clinical research;
the intellectual environment within the department and related disciplinary areas that are directly relevant to the applicant's research interests;
the department's support of mentoring by key senior faculty;
the plans and commitments the department and institution have made to assist the applicant to accomplish his/her career goals;
the space that the institution has committed or will commit to the individual; and
the institution's commitment to allow the applicant to devote 50% of his/her time to clinical research.

*Applicants who are part of a Department of Medicine may have their division chairperson write this letter.

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Principal Investigator

Letter of Support from Mentor (Maximum 2 pages)

Replace this page with a letter of support from the applicant's research mentor. This letter should indicate his/her willingness to serve as the applicant's mentor, and, in that capacity, to meet with the applicant at least twice a month. The letter must be no more than two pages in length. Letters longer than two pages will not be accepted.

Principal Investigator

2018 Young Investigator Supporting Materials

Voelcker FundTemplate

Principal Investigator Information

Full Name:

LastFirstMI Degrees

Institution:

Institutional Commitment Letter

Name:

Title:

Institution:Department:

Letter of Support from Mentor

Mentor 1:

Title:

Institution:Department:

Mentor 2:

Title:

Institution:Department:

Consultant/Collaborative/Contractual Arrangements

1. Name:Institution:

2. Name:Institution:

3. Name:Institution:

4. Name:Institution:

Voelcker Fund Young Investigator Award on Translational Science

Principal Investigator

Principal Investigator

Signature ______Date Submitted ______

FORMATTING INSTRUCTIONS

Principal Investigator

Table of Contents

Part 1: Proposal

Part II: Institutional Support Documents

Principal Investigator

Principal Investigator

Principal Investigator

Personnel (Name/Job Title)%Effort%SalarySalaryFringeSubtotal

Equipment

Summary Budget

Total Budget

Total

Other Sources of Research Support

LastFirstMI Degrees

Signature Date Submitted