2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Title Page
Project Title: (limit to 85 characters including spaces)
Principal Investigator (PI):
PI’s Position/Title:
Institution:
Address:
Telephone:
E-mail:
AACP Member Number:
Co-Investigator/Retail Food Market Professional:
Co-Investigator/Retail Food Market Professional Title:
Food Market (FMI Member) Establishment Name:
Address:
Telephone:
E-mail:
Grant Period (nine months or less):
Start date
End Date
Amount Requested: $
Dean’s Name and E-mail Address:
Co-Investigator/Retail Food Market Professional’s Supervisor Name and E-mail Address:
Signatures: (Scanned original signatures are required)
Principal Investigator
Date
Department Head
Date
Dean
Date
Co-Investigator/Retail Food Market Professional
Date
Co-Investigator/Retail Food Market Professional’s Supervisor
Date
2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Abstract Page
Project Title:
Principal Investigator and Co-Investigator/Retail Food Market Professional:
Abstract (Do not exceed the space provided):
Specific Aim(s):
Approach and Methods:
Expected Results:
Significance:
2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Budget Page
Directions: Please list the supplies/materials and the approximate dollar amount by the following
categories that are needed to carry out the research project. Do not exceed the space provided.
Personnel: (student or other hourly personnel only)
Supplies:
Equipment: (small equipment only, computers are not allowed)
Operations (i.e., computer time, telephone, postage):
Travel (for the purpose of generating research results, not for meeting attendance):
Other (specify):
TOTAL BUDGET REQUEST: $
2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Biographical Sketch Form
Do not exceed the space provided; use single space and a minimum of 11 point font size; may not
exceed two pages.
Principal Investigator:
Education:
Dates
University
Degree/Major
Professional and Teaching Experience: (Include postdoctoral experience):
Dates (From-To)
Title/Position
Institution/University
Biographical Sketch Form (Principal Investigator), Page 2
Active and Pending Research Support:
Please supply the following funding information for all currently active or pending research projects in
which you are involved as the Principal (PI) or Co-investigator (CI) including intramural grants.
Project Title:
Sponsor:
Amount:
Period:
Role and %FTE:
Active or Pending?
Publications relevant to this application:
Other experiences relevant to this application:
I hereby certify that this HWPPI application has not been submitted to another funding agency or has
been submitted to the above indicated agency for consideration.
Signature:
Date:
2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Biographical Sketch Form
Do not exceed the space provided; use single space and a minimum of 11 point font size; may not
exceed two pages.
Co-Investigator/Retail Food Market Professional:
Education:
Dates
University
Degree/Major
Professional and Teaching Experience: (Include postdoctoral experience):
Dates (From-To)
Title/Position
Institution/University
Biographical Sketch Form (Co-Investigator/Retail Food Market Professional), Page 2
Active and Pending Research Support:
Please supply the following funding information for all currently active or pending research projects in
which you are involved as the Principal (PI) or Co-investigator (CI) including intramural grants.
Project Title:
Sponsor:
Amount:
Period:
Role and %FTE:
Active or Pending?
Publications relevant to this application:
Other experiences relevant to this application:
I hereby certify that this HWPPI application has not been submitted to another funding agency or has
been submitted to the above indicated agency for consideration.
Signature:
Date:
2013 AACP/FMI Foundation Health and Wellness Pharmacy Practice Ideation (HWPPI)
Award Application
Application Sections (continued)
Research Narrative (Use regular 8.5” x 11” paper, limit to six (6) typed pages, single space, no
more than 6 lines per vertical inch, and a minimum of 11 point font size with one inch of margin
on all sides)

The Research Proposal Narrative must contain the following headings:
o Nature of Project: a brief description of the purpose and goals of the proposed
work, including appropriate background material.
o Objectives: a clear statement of expectations for the project.
o Methods: the methods to be used for the study, including data analysis and
interpretation; the indicators that will be used to measure the project’s success
and analysis of results.
o Timeline for Completion of the Project: a maximum of nine months.
o Contribution to Career: the relationship between the project and the applicant’s
career objectives and the role of this project in relation to future funding efforts.
o Significance of the Project: the ways in which the project will contribute to the
advancement of the new knowledge, the contribution that the project will make to
the applicants school and retail establishment, and the applicants plan for
dissemination or publication of the research results.
o Budget Justification: justification for requested budget items. This should be in
sufficient detail to enable reviewers to evaluate how funds will be used to support
the proposed research project.
Additional Items (if applicable)
Human Subjects Research IRB Approval Letter
Other Supporting Documents (e.g., Appointment letter for regular clinical or research-track
faculty)
This application form, including the appropriate original signatures,
Research Narrative, and additional items (if applicable) must be
uploaded as a Single PDF Document to the Food Marketing Institute
Foundation (FMIF) Health and Wellness Pharmacy Practice Ideation
Award submission site via the AACP Online Awards Submission
website located at
http://www.aacp.org/career/awards/Pages/awardssubmission.aspx.
Please contact HWPPI@aacp.org with any questions.