SUBMISSION DATE
TEDDY DATA
ANALYSIS APPLICATION
TITLE OF PROJECT
PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR
NAME (Last, first, middle)
DEGREE(S)
POSITION TITLE
MAILING ADDRESS (street, city, state,
zip)
DEPARTMENT, SERVICE, LABORATORY, OR EQUIVALENT
EMAIL ADDRESS:
MAJOR SUBDIVISION
TELEPHONE AND FAX
DATES OF PROPOSED PERIOD OF
SUPPORT (month, day, year –MM/DD/YY)
COSTS REQUESTED FOR INTIAL BUDGET
PERIOD
COSTS REQUESTED FOR PROPOSED PERIOD
OF SUPPORT (maximum of 2 years)
From
Direct costs ($)
Direct costs ($)
Through
APPLICATION ORGANIZATION
Total costs ($)
Total costs ($)
TYPE OF ORGANIZATION
Name
Address
ADMINISTRATIVE OFFICIAL TO BE NOTIFIED IF AWARD
IS MADE
OFFICIAL SIGNING FOR APPLICANT ORGANIZATION
Name
Title
Title
Address
Name
Address
Tel:
Tel:
Email:
Email:
Fax:
Fax:
RESEARCH PLAN
1. INTRODUCTION
Briefly summarize the background information for the proposed analysis. The types of data to which this proposal applies should also be included
(e.g. dietary biomarkers, gene expression, metabolomics, microbiome, proteomics, etc.).
2. SPECIFIC AIMS
Identify the goals, hypotheses, and expected outcome(s), including the potential impact that the results will have for the TEDDY Study.
3. SIGNIFICANCE
Describe how the proposed project will improve scientific knowledge, technical capability, and/or clinical practice in diabetes research and beyond.
Revised as of October 16, 2014
4. INNOVATION
Describe any novel theoretical concepts, approaches or methodologies, and/or instrumentation to be developed or used, as well as any advantage
over existing methodologies, instrumentation or intervention(s).
5. APPROACH
Describe the analysis plan, overall methodology, and timelines for accomplishing the specific aims of the project. Identify potential complications,
alternative strategies, and benchmarks for success anticipated to achieve the aims.
6. RELEVANT PRELIMINARY STUDIES
Discuss any relevant research experience and/or preliminary studies conducted by the proposed investigators that inform their contribution to the
proposed analysis.
7. BIBLIOGRAPHY/REFERENCES CITED
List any references used to formulate your analysis plan and/or mentioned above in this proposal.
Revised as of October 16, 2014
Program Director/Principal Investigator (Last, First, Middle):
FROM
DETAILED BUDGET FOR INITIAL BUDGET PERIOD
DIRECT COSTS ONLY
THROUGH
List PERSONNEL (Applicant organization only)
Use Cal, Acad, or Summer to Enter Months Devoted to Project
Enter Dollar Amounts Requested (omit cents) for Salary Requested and Fringe Benefits
ROLE ON
PROJECT
NAME
Cal.
Mnths
Acad.
Mnths
Summer
Mnths
INST.BASE
SALARY
SALARY
REQUESTED
FRINGE
BENEFITS
TOTAL
PD/PI
SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
CONSORTIUM/CONTRACTUAL COSTS
DIRECT COSTS
SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD (Item 7a, Face Page)
CONSORTIUM/CONTRACTUAL COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD
$
FACILITIES AND ADMINISTRATIVE COSTS
$
Revised as of October 16, 2014