B-AIProj: Application Information

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16 Νοε 2013 (πριν από 3 χρόνια και 9 μήνες)

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National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
1

of
9



Required information

E
nsure you consult the

Advi
c
e and instructions for a
pplicants
’ document

for
this scheme when filling out the pages/sections below.

Avoid using line breaks, i.e. paragraphs, in this off
-
line form as it will
distort the character count.


B
-
AIP
roj:
Application Information


Career Disruption



Is any member of the CI team claiming a Career
Disruption (CD)?
S
elect an
option from the drop down list
-Select-


If you select:




Op
tion 2, all CD claims must be included in the Detailed Background and
Research Plan PDF upload;




Option 3, all CD claims are considered highly sensitive, and must be
emailed to NHMRC (refer
to the ‘
Advice

and instructions for applicants’
document for this
scheme
);




Option 4, some CD claims will be included in the Detailed Background and
Research Plan PDF upload, and highly sensitive claims will be emailed to
NHMRC.


New Investigator


NHMRC seeks to provide support each year to researchers who have not
pr
evi
ously been funded by NHMRC.
All Chief Inves
tigators on an application
for N
ew
Investigator
funding must meet the criteria detailed in the
f
unding
r
ules

for this scheme
.

Refer to th
ese rules

for eligibility criteria.



Is this application for New Investi
gator funding?
-Select-


If Yes, provide a justification


Enter text here


(2000 character limit including spaces and line breaks).



Funding Source




Select the organisation(s) from which funding is sought. Check all that
apply. At least one organisation mus
t be selected. If no organisation
is
selected, the application will

be assessed against NHMRC’s requirements
only.


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
2

of
9



Required information



Applicants may also seek funding from other agencies
.
Applicants
intending to do this can select these organisations below.




Funding partn
ers may have different eligibility requirements or require
additional information. NHMRC recommends applicants seeking funding
familiarise themselves with funding partner requirements

and the NHMRC
f
unding
r
ules

for this scheme

(s
ection 8).




NOTE:
if
the boxes below are selected, your application and assessment
information will be passed onto these agencies for their information.




Refer to the
f
unding
r
ules

for information
.




NHMRC


Cancer Australia & Funding Partners


Cancer Council


Consent to disclose personal information
to third parties


As notified in the Project Grants Funding Rules, funding arrangements
through a third party are available subject to additional eligibility criteria. If you
wish to be considered for funding by a third party, please select the relevant
or
ganisation(s)

from the boxes below. For the purposes of the Privacy Act
1988 (Cth), applicants should be aware that if they indicate they wish to be
considered for funding by a third party, NHMRC will provide their personal
information, that is, the applic
ation, snapshot reports and information about
the results of NHMRC’s assessment outcome to the third party. The third
party may then provide that information to one of their funding partners.
Where NHMRC is aware that a third party has funding partners, th
ey have
been listed. The purpose of providing such information to the third party is to
enable them (or their funding partners) to assess the application’s eligibility for
funding under the relevant scheme.


◙ Do you consent to NHMRC providing this
application, snapshot reports and
information about the results of NHMRC’s assessment of this application to
third parties?


-Select-



Have you sought consent from Chief Inv
estigators (CIB
-
CIJ) for NHMRC to
provide this application, snapshot reports and information about the results of
NHMRC’s assessment of this application to third parties?


-Select-


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
3

of
9



Required information

Select the funding agencies you consent to NHMRC providing your
application and associated reports to for consideration.



Cancer Australia


Cancer Council Victoria


Cystic Fibrosis Australia


Department of Health and Ageing


Duchenne Foundation


HeartKids Australia Inc


Your Administering Institution/Actual Institution


Your State/Te
rritory Government Departments


Please note


• Cancer Council Victoria may provide information to Cancer Council ACT,
Cancer Council New South Wales, Cancer Council Queensland, Cancer
Council South Australia, South Australian Health & Medical Research
Inst
itutes, Cancer Council Tasmania, Cancer Council Victoria and Cancer
Council Western Australia. • Duchenne Foundation may provide information to
Facioscapulohumeral Dystrophy Global Research Foundation Ltd., Spinal
Muscular Atrophy Association of Australia
Inc., Muscular Dystrophy
Foundation Australia and Muscular Dystrophy Australia


Associate Investigator permissions


◙ Have you sought agreement from Associate Investigators for their name to
be included in this application?


-Select-




B
-
PSI: Priority/Special Initiatives




Each year N
HMRC designates a small number of health areas in which it
encourages applications.
R
efer to the
f
unding
r
ules

for this scheme
for

further information and descriptions

of current NHMRC priority and special
initiatives.




If your application relates to the NHMRC’s priority area of Indigenous
health you must address this in Part A of the application under ‘Aboriginal
and Torres Strait Islander Research’.




Refer to the
f
unding
r
ules

for this scheme
for further information and
descriptions of current NHMRC priority and special initiatives.


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
4

of
9



Required information



From the lists below, select the initiative(s) applicable to this application
and

provide a comment to support your selection in the justification text
box.


Priority/Special Initiatives



Name


Indigenous Health


Electromagnetic Fields


Hearing Loss Prevention


Justification


If you have selected a priority/special initiative above, provide a justification


Enter text here

(2000 character limit including spaces and line breaks
)
.




B
-
PR: Proposed Research




Your research proposal should be de
veloped in accordance with the

A
dvice and
i
nstru
ctions for

a
pplicants
’ document

for this scheme.




Where

appropriate, the relevance of Aboriginal and/or Torres Strait
Islander health is to be stated.




Ensure

you use the naming convention as described in the

Advice and
instructions for

a
pplicants

document

for this scheme
.



Proposed Research (upload)


Please attach a PDF file for upload (2MB limit). The PDF file MUST not
exceed 2MB in size. NHMRC uses the commonly accepted definition (used in
reference to computer memory) of 1MB being equal to 1,048,576 bytes,
therefore any application exceeding 2,097,1
52 bytes will not be accepted.
Applicants are advised to retain a copy of the PDF file they submit.




B
-
CP: Participation


Complete this page for each entry. You will need to create a new page for
further entries.


Team Member


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
5

of
9



Required information


Enter name he
re



Participation

-

Provide a brief summary of your participation in the broad
research plan proposed in this application
.


Enter text here


(1000 character limit including spaces and line breaks
)



B
-
PB Proposed Budget


Using research facilities


Applicants often need to purchase services from third parties to enable

their
research to be successfully undertaken.


Such research facilities include biospecimens and associated data from
biobanks or pathology services, and from organisations such as non
-
human
primate colonies, the Australian Twin Registry, Cell Bank Austra
lia, the Trans
-
Tasman Radio Oncology Group and from organisations that provide clinical
trials services.


This list is illustrative and is by no means exhaustive.



Is this application using services provided by a research facility?


-Select-


Please note, the costs of using services provided by research facilities should
be included in the budget as Direct Research Costs and are to be fully
justified.


Applicants should cons
ult with research facilities to ensure that the services
they require can be provided and that the charges included in the research
budget reflects their charges. Letters from research facilities confirming their
collaboration can be uploaded below:


Pleas
e attach a PDF file for upload (2MB limit). The PDF file MUST not
exceed 2MB in size. NHMRC uses the commonly accepted definition (used in
reference to computer memory) of 1MB being equal to 1,048,576 bytes,
therefore any application exceeding 2,097,152 by
tes will not be accepted.
Applicants are advised to retain a copy of the PDF file they submit.


Direct Research Costs

(eligible costs are outlined in the relevant
f
unding
r
ules
)


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
6

of
9



Required information

Enter the value of Direct Research Costs for each year
.

Only the relevant
number of years should be
completed
.


Year 1 ($AUD)

0

Year 2 ($AUD)

0

Year 3 ($AUD)

0

Year 4 ($AUD)

0

Year 5 ($AUD)

0


Give details and justify each item of Direct Research Costs



Enter text here


(6000 character limit including spaces and line breaks
)


Equipment

(eligible costs are outline
d in the relevant
f
unding
r
ules
)


Enter the value of all items of equipment for each year. Only the relevant
number of years should be
completed

(total equipment budget must not
exceed $80,000).


Year 1 ($AUD)

0

Year 2
($AUD)

0

Year 3 ($AUD)

0

Year 4 ($AUD)

0

Year 5 ($AUD)

0


Justification for your Equ
ipment request



Enter text here


(2000 character limit including spaces and line breaks
)




B
-
PPRC: Publications, Papers, Reports and Contribution


In the fields
below, provide comments on the most relevant and/or significant
publicatio
ns, papers, reports (including t
echnical) and other contributions that
relate to this application.


C
omplete this page for each entry. You will need to create a new page for
further

entries.



Team Member



Enter name here


Publications, Papers, Reports &Contribution: in the last 5 years

National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
7

of
9



Required information


Significant publications, papers, reports and other
contributions in the last
five years or equivalent full time research


Enter text here


(2000 character limit including spaces and li
ne breaks)


Publications, Papers, R
eports &Contribution: over the course of your
career



Other significant publications, papers, reports and other contributions over
the course of your career


Enter text here


(2000 character limit including spaces and li
ne breaks)




B
-
NPA:

Nomination of Possible Assessors


If you consider that there is a suitably qualified assessor able to objectively
ass
ess this area of research

you may nominate up to two national and two
international assessors below. This information will be included in the
assessment process but will not necessarily be acted upon.


If the nominee has an RGMS account, they must be selec
ted from the list of
account holders available in RGMS. If the nominee does not have an RGMS
account, their contact details will need to be entered manually in
to

the fields
below.


If the national assessor is an existing RGMS account holder, enter them
here:


National Assessor 1 with RGMS account
Enter name here


National Assessor 2 with RGMS account
Enter name here


If the national assessor is NOT an existing RGMS account holder, enter
them here:



National
Assessor 1





q楴汥i
ⵓ-汥捴-


乡Ne







bxpe牴r獥†








National
Assessor 2





q楴汥i
ⵓ-汥捴-


乡Ne







bxpe牴r獥†







National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
8

of
9



Required information

Email







Phone







Fax







Email







Phone







Fax









If the international assessor is an existing RGMS account holder, enter
them here:


International Assessor 1with RGMS account
Enter name here


International Assessor 2 with RGMS account
Enter name here


If the international assessor is NOT an existing RGMS account holder,
enter them here:



International
Assessor 1





q楴汥i
ⵓ-汥捴-


乡Ne







bxpe牴r獥†







bma楬†







mhone†







䙡x†








International
Assessor 2





q楴汥i
ⵓ-汥捴-


乡Ne







bxpe牴r獥†







bma楬†







mhone†







䙡x†









B
-
NA:
Non
-
assess
or




You may nominate a particular assessor not to be approached to assess
the application. If the nominee has an RGMS account, they must be
selected from the list of account holders. If the nominee does not have an
RGMS account, their contact details
will need to be entered manually into
the fields below. Provide the name, institution and email address of the
requested non
-
assessor for the request against the following criteria:


National Health and Medical Research Council

Research
Grants Management System


Application Detail


Part B

2013 Project Grant funding commencing 2014


Application Detail


Part B


Project Grants_v2
-
3



Page
9

of
9



Required information



Conflict of Interest


You believe the person may have a Conflict of
Int
erest that would affect their ability to be impartial.




Other Concerns


That lead you to believe that the assessor would be
incapable of giving a fair assessment because of unreasonable bias.




Your request will be made known only to certain persons
directly involved
with completing this application and those directly involved in the selection
of assessors.

This information will not appear on snapshot reports
associated with this application.


If the non
-
assessor is an RGMS account holder, enter them

here:


Non
-
Assessor with RGMS account
Enter name here


If the non
-
assessor is NOT an RGMS account holder, enter them here:


Non
-
assessor Title
-Select-


Name







Institution







Email








Justification


Enter text here


(1000 character limit including
spaces and line breaks)