AMHSCN New Investigator Seed Funding Grant Competition
Deadline: June 30th, 2014
Type of Funding Requested:
Pilot Grant: for new projects, smaller in scope by definition, from which pilot data will be generated
to form the foundation of a larger follow-up study
Innovation Grant: new research project
Educational/Translation Project
Other: not fitting into any other category; must be described in detail
A.
ADMINISTRATIVE DETAILS:
Title of Project:
Therapeutic area (choose one):
Depression
 Adolescent Development
Addiction
Principal Investigator:
Name
Position
Address
Phone
Email
Co-Principal Investigator: If applicable, please indicate any co-principal investigator(s) here.
Name
Position
Address
Phone
Email
Collaborators: Please list the name, position, affiliation and contact information for each collaborator.
Please attach CVs of Principle Investigator(s) and Co-PIs, if relevant.
Lay summary (max 10 lines):
Relevance of application to AMHSCN:
yes
no
pending
Research Ethics Board approval: yes
no
pending
Health Canada CTA approval:
Other approvals:
Animal Care
Biohazard
not applicable
Containment
Approvals: Please obtain the signatures indicating review and approval as indicated.
Principal Applicant:
Signature______________________________________
Date_______________________
Section Head, Department Head or Institute Director:
Name ___________________________________________________________________
Signature______________________________________
Date_______________________
B.
RESEARCH PROPOSAL: Maximum of 2 pages in length (minimum 12 point font, 1 inch
margins) not including figures or references.
Please include the following sections/information:
Background/Justification/Therapeutic area in which research falls
Purpose, specific objectives, hypothesis or study question
Study design and methodology
Project Relevance and Impact, including dissemination strategy
PLEASE APPEND 4 PAGE PROPOSAL
C.
OTHER INFORMATION:
1. Ethical issues and study limitations (if any)
2. Timeframe
D.
FUNDING INFORMATION SUMMARY: The maximum award amount is $15,000, expendable
over one year. Projects should be completed within the one year duration.
Anticipated start date of the project:
Proposed project duration:
Have you secured other funds for this proposal:
E.
Yes
No
Budget Request: Please append a budget justification.
F: SUBMISSION
Submit 1 electronic copy of all documents (application form, proposal, budget, CV’s) to Victoria Suen,
Assistant Scientific Director, Addiction and Mental Health Strategic Clinical Network, 780-735-0294;
Victoria.Suen@albertahealthservices.ca
G: QUESTIONS
If you have questions about the granting process, contact
• Victoria Suen, Victoria.Suen@albertahealthservices.ca or at 780-735-0294