<p> v1.2 (21st July 2017)</p><p>HOMER GRANT APPLICATION WORKSHEET</p><p>Please DO NOT submit this worksheet as your application. This worksheet is meant for applicants to prepare for submitting your grant application. </p><p>Only online applications are accepted.</p><p>Please tick () the category of grant for your proposal: Category A (up to $5,000 for 1 year) Category B (up to $10,000 for up to 2 years)</p><p>Please tick () the relevant research area(s) of proposed research: Interprofessional Education and Collaborative Practices (IPECP)</p><p>Work-based Learning</p><p>Faculty Development</p><p>Others ______</p><p>Project Title: </p><p>Please copy-&-paste additional sections for PI, co-Investigator, or collaborator as required for your application preparation.</p><p>1 v1.2 (21st July 2017)</p><p>A. Principal Investigator 1 (contact PI)</p><p>Salutation: Full Name: Institution: Department: Designation: Contact number: (Office) (Mobile) Email:</p><p>A. Principal Investigator 2</p><p>Salutation: Full Name: Institution: Department: Designation: Contact number: (Office) (Mobile) Email:</p><p>A. Principal Investigator 3</p><p>Salutation: Full Name: Institution: Department: Designation: Contact number: (Office) (Mobile) Email:</p><p>B. Co-Investigator 1</p><p>Salutation: Full Name: Institution: Department: Designation: Contact number: (Office) (Mobile) Email:</p><p>B. Co-Investigator 2</p><p>2 v1.2 (21st July 2017)</p><p>D. Project Details</p><p>D1. Research question(s) and hypotheses (if any): (please limit to 3000 characters, ~ 500 words)</p><p>D2. Context / empirical / background literature of proposed research areas(s) relevant to the research project: (please limit to 9000 characters, ~ 1500 words)</p><p>D3. Importance of proposed research question(s) and potential contribution to theory and practice of health professions education: (please limit to 3000 characters, ~ 500 words)</p><p>D4. Please provide details if the proposed research project is a development of a previous project: (please limit to 3000 characters, ~ 500 words)</p><p>3 v1.2 (21st July 2017)</p><p>D5. Details of the research methodology and data analysis: (please limit to 9000 characters, ~ 1500 words)</p><p>D6. Role and duties of PI(s) and collaborator(s) Role Specific Duties / Expertise for # Name, Institution (PI, Collaborators etc) Research Project 1 2 3</p><p>D7. Projected timeline / Milestones Activity Time needed # (e.g., recruiting research assistants, data collection, Month – Year pilot testing, submission of progress and final (in weeks) reports, etc) 1 2 3</p><p>E. Budget</p><p>Estimated quantity # Description of item Purpose Estimated amount and cost per unit 1</p><p>4 v1.2 (21st July 2017)</p><p>2 3 4 5 Total grant amount $ requested:</p><p>Please DO NOT submit this worksheet as your application. This worksheet is meant for applicants to prepare for submitting your grant application. </p><p>Only online applications are accepted.</p><p>5</p>