project proposal form

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Invest in ME Research
Charity Number 1153730
RESEARCH GRANT APPLICATION FORM
A. PROJECT INFORMATION:
Project Title
Date of Application
Proposed Start Date
Proposed Completion Date
B. PROPOSED PROJECT TEAM :
Primary:
Secondary:
Other team members:
C. DETAILS of ORGANISATION
Name of Organisation where
research is to be performed
Address
Email
Telephone Nr
D. PROJECT DESCRIPTION
1. Brief Description
Please include objectives, significance and timescales
Invest in ME Research, PO Box
1 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 1 of 7
Invest in ME Research
Charity Number 1153730
2. Background:
Please provide a brief background to this project.
Invest in ME Research, PO Box
2 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 2 of 7
Invest in ME Research
Charity Number 1153730
3. Program of work.
Please include descriptions of Patient selection and sample collection, Assessment, Analysis
performed, Statistical analysis:
Use separate page(s) as necessary
Invest in ME Research, PO Box
3 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 3 of 7
Invest in ME Research
Charity Number 1153730
3. Expertise of the team:
4. How Does This Align With IiME Objectives/What is the Justification for Project
D. REFERENCES (up to 5)
Invest in ME Research, PO Box
4 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 4 of 7
Invest in ME Research
Charity Number 1153730
F. STATISTICAL SUPPORT
E.
G. ETHICS:
FUNDING What arrangements for ethical approval/regulations will be made
Required funding for this project: Please provide breakdown of costs
Conditions of funding (eg Home/EU)
Are there any other costs associated with this project?
Year 1
Details
amount
home/EU
Year 2
amount
Year 3
Amount
Invest in ME Research, PO Box
5 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 5 of 7
Invest in ME Research
Charity Number 1153730
Will the staff be lab based?
I. SUBJECT AREAS AND KEYWORDS
Which subject area does the project fall within (select one only):
applied economics
others in allied to medicine
applied microbiology
others in medicine and dentistry
cell biology
parasitology
clinical medicine
physiology
immunology
pre-clinical medicine
medical microbiology
psychology
nutrition
virology
Biological & Medical Sciences
Agricultural Sciences
Endocrinology
Biochemistry
Bioinformatics
Biomedical Engineering
Biophysics
Biotechnology
Botany / Plant Science
Cancer / Oncology
Cell Biology
Dentistry
Ecology & Conservation
Evolution
Food Science / Nutrition
Genetics
Immunology
Marine Biology
Medical / Biomedical Physics
Medical / Clinical Science
Microbiology
Molecular Biology
Neuroscience / Neurology
Obstetrics, Gynaecology &
Reproduction
Parasitology
Pathology
Pharmacology / Toxicology
Physiology & Sports Science
Public Health & Epidemiology
Structural Biology
Veterinary Medicine
Virology
Zoology / Animal Science
KEYWORDS. Please list below keywords for use when advertising projects.
OTHER FUNDING SOURCES. Please provide details of funds for this project secured elsewhere, or any
applications made elsewhere to fund this project.
Invest in ME Research, PO Box
6 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 6 of 7
Invest in ME Research
Charity Number 1153730
OTHER RELEVANT INFORMATION.
Invest in ME Research, PO Box
7 561, Eastleigh SO5O OGQ, Hampshire, UK
Telephone: 02380 251719 – 07759 349743
Web: www.investinme.org
Email: info@investinme.org
Page 7 of 7
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