[SHORT TITLE]
[CHAMPION]
EXPRESSION OF INTEREST (EOI) TO APPLY TO
THE TERRY FOX TRANSLATIONAL CANCER RESEARCH PROGRAM (2016)
Deadline: Monday June 1st, 2015, 5.00 pm Pacific Daylight Time
Email to translation@tfri.ca
Full Name of Champion1: [Last Name, given name, middle names, title]2
Mailing Address: [Institution, department, street address, city, province, postal code]
Email: [email address]
Telephone #: [office telephone #]
Laboratory Telephone #: [lab telephone #]
PROPOSED PROJECT AREA: [Describe the proposed project area in a phrase]
SHORT TITLE: [2-3 word descriptor]
SUMMARIZE TRANSLATIONAL CANCER RESEARCH QUESTION(S) TO BE ADDRESSED
(one paragraph)
1
The Champion is the individual who submits the Expression of Interest. The Champion may become, but need not
be, the Leader or Co-Leader of the Project if an EOI is chosen to move forward
2 Square bracketed elements in grey are designed to be replaced by the Champion with details requested.
EOI Translational Project
1
[DATE]
[SHORT TITLE]
[CHAMPION]
OUTLINE THE POTENTIAL TRANSLATIONAL DELIVERABLES THAT WILL IMPACT HEALTH
OUTCOMES FOR PATIENTS (one paragraph)
DESCRIBE THE EXPERTISE AND UNIQUE STRENGTHS AND RESOURCES POSSESSED BY
CANADIAN CENTRES TO ADDRESS THE QUESTIONS ADDRESSED IN PROPOSAL (one
paragraph)
EOI Translational Project
2
[DATE]
[SHORT TITLE]
[CHAMPION]
PROVIDE A RATIONALE FOR WHY THE TERRY FOX RESEARCH INSTITUTE SHOULD
CONSIDER SUPPORTING YOUR TRANSLATIONAL CANCER RESEARCH PROPOSAL (one
paragraph)
CHAMPION AND OTHER INTERESTED PARTIES
Each person whose name and signature is entered below on this expression of intent agrees to work
together to organize a workshop on the ideas described in this EOI if requested to do so by the Terry Fox
Research Institute. Attach the TFRI CV of the Champion and leading applicants to this EOI.
CHAMPION
Name
Signature
Date
Name
Signature
Date
EOI Translational Project
3
OTHER INTERESTED PARTIES
[DATE]
[SHORT TITLE]
[CHAMPION]
KEY REFERENCES
(include key references including PubMed IDs to support your translational cancer
research Proposal AND references to any intellectual property held or applied for that
this Proposal will develop. Disclosure of the names of any licensees of said intellectual
property is also required)
EOI Translational Project
4
[DATE]
[SHORT TITLE]
[CHAMPION]
PROVIDE AN INCLUSIVE TABLE OF POTENTIAL INVITEES TO A PAN-CANADIAN
WORKSHOP TO DISCUSS THE IDEAS CONTAINED IN THIS EOI – INCLUDE THE
CHAMPION AND OTHER INTERESTED PARTIES. (Target Meeting Size ~30 Persons)
#
Name
Affiliation
Expertise / Contribution
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
EOI Translational Project
5
[DATE]