Cross-Faculty Research Grant Application Form 2009

VISA RESEARCH GRANT APPLICATION FORM

INTRODUCTION

The Research Grant provides seed funding of up to S$20,000 per project for novel projects. The duration for each project is up to two years. The grant aims to encourage academic staff that could help investigators develop projects to a level that can compete for funding from external funding bodies or from ARF, MOE.

ELIGIBILITY INFORMATION

Applicants for the Research Grant must meet all of the following requirements:  Projects must address issues relevant to ageing from a broad perspective.  Principal Investigators must be full time NUS academic staff (Asst Prof / Assoc Prof / Prof) from the Faculty/School.  Funding requested should be for new research ideas and not for supplementing existing projects / collaborations.  Project must be supported by respective Heads of Departments (or nominee).

APPLICATION & SUBMISSION

 Research proposal must be prepared using the prescribed form on www.nus.edu.sg/lsi  You may add pages or sections where necessary.  Main PI/ Faculty is responsible for the completeness of the proposal submission to Life Sciences Institute (LSI).  Proposals must be submitted through main PI’s Head of Department.  Only proposals properly completed with relevant supporting documents attached will be accepted for evaluation and assessment for awarding of grants.  You should submit two original hardcopies and one MS Word softcopy.  All proposals to be submitted to LSI by 26 February 2010. Proposals are to be sent to:

Mrs Ellice Lim Senior Manager Life Sciences Institute 28 Medical Drive #05-02 Singapore 119456

CONTACT

For queries, please contact: Mrs Ellice Lim Tel: 6516 7528 Email: [email protected]

Revised_Dec09 1 VISA 2010 1. PROPOSED RESEARCH PROJECT:

Project title:

2. APPLICANTS*

Section A – Details of Applicants

a. Applicant 1 – Main applicant & Department who will be administering the grant (i.e. sign/approve POs, purchases etc) (Please attach a 1-page CV containing a list of your qualifications, appointment, any distinctions and up to 10 of your most recent relevant papers with full titles and full journal name and page numbers):

Name: Title, Name Department: Faculty: Telephone: E-mail:

Grant/s Applied Status: Proposed Funding Agency/ies Amount (Pending Approval) S/N PI, Co-PI, Project Title Duration of Award Please list co-funding Requested Collaborator (MM-YY to MM-YY) Please add records if (please indicate Grantors, if applicable (S$) one) applicable

TOTAL Grant/s Status: Project Title Funding Agency/ies Amount Duration of Award Awarded S/N PI, Co-PI, (WBS No.) Please list co-funding Awarded (MM-YY to MM-YY) (Current) Collaborator (please indicate Grantors, if applicable (S$) one) Please add records if applicable

Revised_Dec09 2 VISA 2010 b. Applicant 2 (please attach a CV as above):

Name: Title, Name Department: Faculty: Telephone: E-mail: Full-time/Part- time: (If Part-time, please indicate appointment ratio)

Grant/s Applied Status: Proposed (Pending Approval) Funding Agency/ies Amount S/N PI, Co-PI, Project Title Duration of Award Please list co-funding Requested Collaborator (MM-YY to MM-YY) Please add records if (please indicate Grantors, if applicable (S$) applicable one)

TOTAL Grant/s Status: Awarded Project Title Funding Agency/ies Amount Duration of Award S/N PI, Co-PI, (Current) Collaborator (WBS No.) Please list co-funding Awarded (MM-YY to MM-YY) (please indicate Grantors, if applicable (S$) Please add records if one) applicable

* (i) If there are more than 2 applicants, please add sections where necessary.

3. DESCRIPTION OF PROPOSED PROJECT:

Revised_Dec09 3 VISA 2010 Project Outline [Please state the aims of the proposed work and its importance. Please also highlight the competency of the PIs in handling the project.] (no more than 150 words):

Aim/Objective of the [Is the aim of this project to gather initial ‘pilot’ data which can be used to later to jointly project: apply for external funding, i.e. from MOE, A*STAR etc?  Yes  No

If ‘no’, please describe the aim of this project.]

Technical [Please describe how the proposed project would be done, the methodology and approach Description of to be adopted.] Project

Deliverables: [Please list the expected deliverables within the project duration of up to two years.]

Proposed start date [Project duration is up to two years. Please indicate the proposed start date of the project.]

4. BUDGET RESOURCES:

Revised_Dec09 4 VISA 2010 a. Proposed project budget breakdown:

DESCRIPTION YEAR 1 YEAR 2 TOTAL ITEM/VOTE [Please list items required] (S$) (S$) (S$)

Expenditure on Manpower

Equipment/Facilities

Other operating expenditure (consumables, materials)

TOTAL (S$)

NOTES: - Project duration is up to two years - Total budget should not exceed $20, 000 - Funds cannot be used for travel unless essential to the aims of the project

b. Brief Justification for the Resources:

Justification ITEM/VOTE [Please provide justification of each of the items required]

Expenditure on Manpower

Equipment/Facilities

Other operating expenditure (consumables, materials)

NOTE: The final approved budget will be administered and managed by Applicant 1 (main applicant) and his/her respective Department.

5. DECLARATION OF ETHICS CONSIDERATIONS/RESEARCH COMPLIANCE

Revised_Dec09 5 VISA 2010 Our project involves (*please delete, where appropriate):

A. Laboratory / Non Laboratory Based Research – Please tick appropriate box 1. Laboratory based research (Laboratory based research projects are defined as those involving the use of chemicals, biological agents, radioactive materials/equipment, heavy machinery or high voltage equipment, etc...) * Yes / No Has the Risk Assessment form been completed and submitted through Department? 2. Non Laboratory based research (Non Laboratory based research projects are defined as those involving the use of computers, surveys etc…) Has the Non-lab based Declaration form been completed and submitted through * Yes / No Department?

B. Human Participants

1. Direct Human Biomedical Research * Yes / No/ (E.g. Clinical trials, physiological research or research with risk of physical or mental NA injury, etc.) 2. Indirect Human Biomedical Research * Yes / No/ (E.g. Epidemiology, research that uses human biological specimens, medical NA information, etc) 3. Other Human Participants Research, please specify: ______* Yes / No/ (E.g. Social psychology, economic or behavioural research in the humanities and NA social sciences) 4. Has ethics/IRB approval been applied for th is project? (Once approval is granted, please forward a copy of the approval certificate) * Yes / No/ NA

C. Animal Ethics

* Yes / No/ 1. Animal experimentation involving euthanasia of animals for tissue harvest NA * Yes / No/ 2. Use of commercially available animal tissues or cells NA 3. Have you obtained IACUC approval for this project? If yes, please provide the following information: * Yes / No/ IACUC Protocol Number: ______NA Expiry Date: ______

Revised_Dec09 6 VISA 2010 6. DECLARATION & ENDORSEMENT

A. DECLARATION & ENDORSEMENT BY MAIN APPLICANT, DEPARTMENT & FACULTY

(I) Declaration by MAIN Principal Investigator

In signing the Grant Application, I declare that the information provided in this application and the accompanying details are true. I understand that the seed funding of our proposed pilot study, if awarded, is to promote active cross-faculty research.

______Name & Designation Signature & Date

(II) Endorsement by MAIN Head of Department (or nominee)

The Department supports/does not support* the above research proposal.

Comments (if any):

______Name & Designation Signature & Date

Revised_Dec09 7 VISA 2010