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 Page 1 APPLICATION FORM NAME: Click here to enter text. ADDRESS: Click here to enter text. PHONE: Click here to enter text. EMAIL ADDRESS: Click here to enter text. CITIZENSHIP/RESIDENCY STATUS: Click here to enter text. RESEARCH INSTITUTION: Click here to enter text. PROJECT START DATE: Click here to enter a date. EXPECTED DATE OF PROJECT COMPLETION: ACADEMIC QUALIFICATIONS: Click here to enter a date. Click here to enter text. Please include certified copies of your qualifications and academic record AWARDS/PUBLICATIONS: Click here to enter text. Please give details of any awards and research papers published CURRENT FINANCIAL ASSISTANCE: Click here to enter text. (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 Page 2 Project Title Click here to enter text. 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 Click here to enter text. AMDF Translational Research Grant – Information and Application Form Page 3 AMDF Translational Research Grant – Information and Application Form Page 4 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. Click here to enter text. 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 Page 5