UTAS – NHMRC APPLICATION COVERSHEET
UTAS Office of Research Services (UTAS ORS)
Research.NHMRC@utas.edu.au
INTERNAL (UTAS ORS) REVIEW: Please submit this signed Application Coversheet to the UTAS ORS Research.NHMRC@utas.edu.au
by the scheme-specific internal closing date.
SUBMISSION OF FINAL APPLICATION: Advice and instructions regarding the final submission of your application to the NHMRC, will
be forwarded by the reviewing officer from UTAS ORS, to the lead investigator.
FOR MORE INFORMATION ABOUT THE UTAS APPLICATION PROCESS, VISIT THE SCHEME WEBSITE:
http://www.utas.edu.au/research-admin/funding/funding-options/nhmrc-funding-opportunities.
SUMMARY APPLICATION INFORMATION
People Support
Funding Scheme:
(please check appropriate box)
Early Career Fellowships
Career Development Fellowships
Research Fellowships
Practitioner Fellowships
TRIP Fellowships
Dementia Research Development Fellowships
Other:______________________________
Research Support
Project Grants
Development Grants
Partnership Projects
Application RGMS ID:
Centres of Research Excellence
Strategic Awards
Program Grants
Other:______________________________
APP
Application Title:
Proposed Start Date:
Proposed End Date:
UTAS Admin School:
UTAS Faculty/Institute:
Has the application/proposal been reviewed by a UTAS
School/Faculty/Institute internal readership scheme (if applicable)?
Ethical clearance required:
Animal
Medical
Social Sciences
Yes
No
Other _____________________________
APPLICANT CONTACT INFORMATION
Lead Investigator Name:
Lead Investigator Email:
Phone:
Alternative Contact Name:
Role:
Alternative Contact Email:
Phone:
RESEARCH CODES AND NATIONAL PRIORITY AREAS
Fields of
Socio-Economic
Research (FOR)
%
(SEO) code(s) (6
%
codes (6 digits)
digits)
Total
100
%
Total
100
%
For assistance, go to Research codes
Strategic
Research
Priorities (SRP)
Total
%
100
%
Types of
Research
(TOR)
Applied
Research
Experimental
Development
Strategic Basic
%
Pure Basic
Total
100%
UTAS – NHMRC APPLICATION COVERSHEET
UTAS Office of Research Services (UTAS ORS)
Research.NHMRC@utas.edu.au
CERTIFICATION BY LEAD INVESTIGATOR
I certify, to the best of my knowledge, that:
1. all the details in this Application Coversheet and the associated funding application are true and complete;
2. all Chief and Associate Investigators identified in the application have agreed, in writing, to its submission and proper inquiries
have been made and I am satisfied that all investigators on this proposal meet the eligibility criteria as specified in the relevant
Funding Rules;
3. certification, in writing, has been provided by Heads of Department of all Participating Institutions, indicating that all appropriate
facilities will be available if this application is successful;
4. I understand the requirements of, and agree to complete, the certification process in RGMS as required for submission of the
application to the NHMRC;
5. I understand and agree that all required ethical and/or biosafety clearances must be obtained before the proposed research can
commence; and
6. I have prepared this application and will conduct activities under the grant in compliance with UTAS policies and procedures
7. I am satisfied that any risks identified in the project will be appropriately managed during the course of the project.
8. I agree to participate in the manner described in the application and to the use my personal information as described in the
NHMRC Privacy Policy.
9. If applicable, I consent to NHMRC providing the application, snapshot reports and information about the results of NHMRC’s
assessment of this application to third parties as indicated on the application.
Signature of Lead Investigator__________________________________________________ Date______________________
CERTIFICATION BY HEAD OF ADMINISTERING SCHOOL/INSTITUTE:
If CIs span multiple UTAS Schools all the HoS/Directors must sign this form. Credit split will determine how block funding will be distributed between
organisational units.
I agree:





that all project costs and all UTAS cash and in-kind contributions have been correctly included
that the project can be accommodated within the general facilities in my School and sufficient working and office space will be
available for staff
I am prepared to have the project carried out in my School under the circumstances set out by the researcher/s
I have noted the amount of time that the investigator/s will be devoting to the project and agree that it is appropriate to existing
workloads
I am satisfied that any risks identified in the project will be appropriately managed during the course of the project.
In instances where the Head of School/Institute is an applicant, the relevant Executive Dean or Research Director should sign this coversheet.
School/Institute 1
%
Split
HOS Signature
School/Institute 2
HOS Signature
HOS Name
(Please Print)
Date
%
Split
HOS Name
(Please Print)
Date
Please email this signed form to Research.NHMRC@utas.edu.au by the scheme-specific internal closing date.