7T application form

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Study Details Submission Form for 7T scanner
Please fill out ALL of the form that is applicable and return via email to
Andrew.Peters@nottingham.ac.uk. Give reasons for not filling out info, e.g. N/A or ‘in progress’
Title
Short name (8 char max)
PI Name
Department
Main Contact
Brief Description
(up to approx 200 char)
Ethics Code
Funding per hour1
Funding Source
Request/justification for lower
than standard funding rates
Approvals/agreements obtained
(e.g R&D, contract with industrial
partner etc.)
Account Code
Activity Code
Cost Centre
Contact Name(s)/email for all
invoicing and financial queries
Split funding into
financial years 2
Details of funding constraints,
e.g. deadlines within the financial
year that money should be spent
Requested Start/End Date of
scanning
Aug12-Jul13 :
Aug13-Jul14 :
Aug14-Jul15 :
Personnel Involved
3
Volunteer/Booking details 4
Total hours required
Project Details 5
Equipment required
6
Pre-project Work 7
Post Project Aims
(PhD, papers, further funding etc)
Data sharing arrangement
(What does ethic say?)
Please also list or attach any relevant papers by yourself or other groups
Notes
1. Standard rate for the 7T is £600 per hour, but please discuss pricing with Andrew Peters. Projects
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3.
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5.
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7.
spanning multiple years should allow an increase of 5% per year.
e.g project from Jun10-Aug11. Approx funding split for £14K might be
Mar01-Jul10 = £2K Aug10-Jul11 £12K.
Name, involvement & responsibility in this project
e.g. (Dr XXXX, paradigm design & writing paper)
e.g. 20 volunteers scanned twice. Booking length 5 hrs to fit 4 subjects per session.
This would then make the total hours required = 50
Please include relevant info for your project this could include scanning sequences to be
used or developed, fmri paradigm design, required equipment etc.
If easier, you may attach previously written documents
For fmri paradigms please attach a diagram to show the timings of events and indicated number
of repetitions of cycle shown in diagram, total length of scan and how many repeats of the whole
scan are necessary.
Info on RF coils / visual / buttons response / EEG etc.
This should include reference to previous scanning done at Nottingham, so that a overview of
scanner use/ previous funding can be seen by the reviewers. E.g. Previous project 2009-2010
called XXX on 3T,funding 10K
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