Application Form

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AMDF Translational Research Grant
Information and Application Form
The Australian Mitochondrial Disease Foundation (AMDF) aims to promote research and
education for the diagnosis, treatment and cure of mitochondrial disorders, and to provide
support to affected individuals and families.
AMDF Translational Research Grants rapidly transform research discoveries into clinical
practice. The foundation funds exceptional researchers who have the capability to turn
around ground breaking research and start to make inroads into treatments.
AMDF Translational Research Grants are charitable grants of $150,000 per year for two
years, offered to an Australian researcher to assist with their work on mitochondrial
disorders. Applicants must be an Australian or New Zealand citizen or have Permanent
Resident Status and not be under bond to any foreign government.
Researchers should be available to make periodic contact with the AMDF Board and be
able to participate in fund-raising and educational events as requested by the AMDF
Board.
Applications will be evaluated by the AMDF Scientific and Medical Advisory Panel based
on the following conditions. If the panel approve of the research, the application will be
forwarded to the AMDF Board for final approval.
APPLICATION REVIEW CRITERIA
1.
scientific merit/ innovation
2.
soundness of methodology
3.
track record of investigator(s)
4.
feasibility of achieving outcomes
5.
budget details (reasonable/potential value of investment to AMDF)
6.
track record related to mitochondrial disease research
7.
potential to leverage more funding (e.g. from NHMRC or elsewhere)
8.
the project will make a contribution to the AMDF
9.
the project will make a contribution to the mitochondrial field
10.
contribution to the investigator’s main field of interest
Each criterion is rated out of 10 such that there is an overall score out of 100.
AMDF Translational Research Grant – Information and Application Form
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APPLICATION FORM
NAME:
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ADDRESS: Click here to enter text.
PHONE:
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EMAIL ADDRESS:
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CITIZENSHIP/RESIDENCY STATUS:
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RESEARCH INSTITUTION:
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PROJECT START DATE: Click here to enter a date.
EXPECTED DATE OF PROJECT COMPLETION:
ACADEMIC QUALIFICATIONS:
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Please include certified copies of your
qualifications and academic record
AWARDS/PUBLICATIONS:
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Please give details of any awards
and research papers published
CURRENT FINANCIAL ASSISTANCE:
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(Please give details of any other grants or
financial assistance you are currently receiving
or have an application in progress for)
AMDF Translational Research Grant – Information and Application Form
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Project Title
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Project Summary
Provide an outline of your research proposal, this should be brief but include key information in a
way that can be understood by AMDF Scientific and Medical Advisory Panel. Successful
applicants will be invited to submit a full application.
Aim for no more than 1 page (Times New Roman, 12 pt font).
Include the following:
 Aims and purpose of the research
 An explanation of the project’s relevance to mitochondrial disease
 How you will do the research
 The expected outcomes of your project
 The expected budget of your project
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AMDF Translational Research Grant – Information and Application Form
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AMDF Translational Research Grant – Information and Application Form
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Lay Project Summary
In no more than 250 words, use simple language to indicate the purpose of the study and how it
relates to mitochondrial disease and the expected outcomes. This will be used by the AMDF for
marketing purposes.
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Signature of Applicant:
_________________________________
Date:
_________________________________
PLEASE SEND THE APPLICATION AND DOCUMENTATION TO:
Rebecca Davis – rebecca.davis@amdf.org.au
AMDF Translational Research Grant – Information and Application Form
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