Banting Research Foundation Discovery Award Application 2015
Complete all items and submit electronically as a PDF to: banting.foundation@utoronto.ca. Use the following convention in naming
your document: LastnameFirstname_BRFApplication_2015.pdf. Attachments, including letter of nomination from Dept/Div Head,
may be included in this PDF or combined in a separate PDF named LastnameFirstname_attachments_2015.pdf.
Mail/courier the original application with signatures to:
Banting Research Foundation
6 Queen’s Park Crescent West, Rm 10
Toronto ON M5S 3H2
Emailed documents must be received by March 16, 2015, 5:00 pm EST. The original hard copy can be mailed/couriered the next day,
or shortly after, but must be in our hands to consider your application complete.
For text portions, use 12 pt Times New Roman, 6 lines per inch (2.5 cm), single-spaced with no condensed type or spacing, and
do not alter the ½” margins of this document. Applications that do not follow these guidelines may be removed from the
competition at our discretion.
___________________________________________________________________________________________________________
Applicant's name, position/rank, department, faculty, institution:
___________________________________________________________________________________________________________
Mailing address, telephone, email address:
___________________________________________________________________________________________________________
Institution at which work is to be carried out:
___________________________________________________________________________________________________________
Short title of research project:
___________________________________________________________________________________________________________
Summary of funds requested:
A.
$
Salary & benefits
B.
$
Materials and supplies
C.
$
Equipment
D.
$
Other (specify)
$
Total (must not exceed $25,000)
___________________________________________________________________________________________________________
Name, title, mailing address, telephone and email address of official in business office responsible for administering the
research grant and to whom cheques should be sent if grant is awarded.
___________________________________________________________________________________________________________
Acceptance of a grant constitutes an agreement that:
 The requirements and conditions governing the award of a research grant by the Banting Research Foundation, as posted on our
website December 2014, are hereby accepted by the applicant and the institution that employs the applicant.
___________________________________________________________________________________________________________
Signatures:
Applicant
Department/Division Head/Chair*
Authorized Officer of Institution
(eg, VP Research or equivalent)
___________________________________________________________________________________________________________
Name:
Name and title:
Name and title:
___________________________________________________________________________________________________________
Date:
Date:
Date:
___________________________________________________________________________________________________________
*Note: The Department/Division Head/Chair may nominate only one applicant per grant competition. Letter of nomination must be included.
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Name of applicantDetails of Funds Requested
Names and qualifications of salaried persons if available should be given. Briefly justify the amount requested in each budget category.
Please append quotations for any equipment and justify the availability and status of similar equipment.
A.
$
Staff
- salary
- benefits
B.
$
Materials and supplies
C.
$
Equipment
D.
$
Other (specify)
$
Total (must not exceed $25,000)
___________________________________________________________________________________________________________
Lay language summary of proposed research. Approximately 100-150 words, in everyday language comprehensible to the general
public and suitable for publication on our website. (If you’re not sure it is in everyday language, please test it on someone outside the
realm of medical research.)
2
Name of applicantSummary of research proposal
The objective(s), hypothesis, approach and research plan should be summarized in this section. Please keep this section to ½ page.
Minimum 12pt font, 6 lines per inch.
Summary of previous work on this or closely related programs by the applicant.
Refer briefly to published work and identify how the work has advanced the state of knowledge in the field in this section. Please keep
this section to ½ page. Minimum 12pt font, 6 lines per inch.
3
Name of applicantResearch Proposal
A clear, concise description of the research proposal should be provided. It should describe the current state of knowledge about the
work proposed, including relevant work done by the applicant, clearly delineate the objectives and research plan, and provide a
rationale for choosing particular methods and approaches. Maximum of 4 pages for this section, including this page. References
and figures can be included on additional pages beyond the 4-page limit of this section. Minimum 12pt font, 6 lines per inch.c
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Name of applicantPersonal Data
A - EDUCATION (including Bachelor, Masters, Doctorate, Clinical Training and License)
Degrees
University or Institution and location
Scientific field
Supervisor
Year
B - RESEARCH TRAINING (Postdoctoral & post health professional training)
Dates
from
Institution
Department
Supervisor
Department
Position
to
C - ACADEMIC POSITIONS HELD and HOSPITAL APPOINTMENTS
Dates
from
Institution
to
___________________________________________________________________________________________________________
Date
Signature
___________________________________________________________________________________________________________
5
Name of applicantPublications
List publications from the past 5 years only, separated in the following categories: 1) papers published, in press, and submitted; 2)
abstracts and presentations. Use additional pages if necessary. One or two manuscripts most relevant to this application may be
appended.
___________________________________________________________________________________________________________
Date
Signature
___________________________________________________________________________________________________________
6
Name of applicantOther Funds
List all sources of support (active and currently applied for) including operating funds from external sources and institutional support
such as start-up funds. Use additional pages if necessary. Do not include copies of the summary or budget pages of grants currently
held or applied for. The signature of your Department/Division Head or equivalent authority must be included at the bottom of this
page as verification of your funding.
Name of applicant
and co-applicants
Funding agency
Title of project
Amount/year
Status
Held/Applied
Support
Period
___________________________________________________________________________________________________________
Date
Signature of applicant
___________________________________________________________________________________________________________
Date
Signature of Department/Division Head
___________________________________________________________________________________________________________
Updated: December 2014
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