Focus Area DynAge APPLICATION FORM: CALL 2015 Submit your application in English as a PDF document to dynage@fu-berlin.de by 30 September 2015. Please use Arial 11-point font (single-spacing) and comply with the provided structure. Reply to all fields in this application form. Instructions in grey and italic type font are directions for filling out the application form appropriately and should be deleted. (A) Project Overview and Information on the Group of Collaborating Applicants 1. Principal Investigators Please name one PI for each co-funding institution involved in the project (i.e., Freie Universität Berlin, FUB; Charité – Universitätsmedizin Berlin, CUB; Deutsches Institut für Ernährungsforschung, DIfE). If two of the co-funding institutions are involved in your project, name two PIs, if all three co-funding institutions are involved, name three PIs. Please name title, first name, surname, affiliation with address, e-mail, telephone and fax number and career stage using the following classification: R1: First Stage Researcher (up to PhD); R2: Recognized Researcher/PostDocs up to about 4 years following PhD; R3: Established Researcher/PostDocs from about 4 years following PhD (researchers who have developed a level of independence; Nachwuchsgruppenleiter, W1 Prof); R4: Leading Researcher (researchers leading their research area or field, W2-/W3-Prof). 2. Collaborating Researchers Please state all participating project partners (title, first name, surname, affiliation, email). Please also state career stage of each collaborating researcher using the following classification: R1: First Stage Researcher (up to PhD); R2: Recognized Researcher/PostDocs up to about 4 years following PhD; R3: Established Researcher/PostDocs from about 4 years following PhD (researchers who have developed a level of independence; Nachwuchsgruppenleiter, W1 Prof); R4: Leading Researcher (researchers leading their research area or field, W2-/W3-Prof). 3. Title of the Project 4. Keywords (max. 5) 1 5. Addressed Disease(s) and Levels of the DynAge Matrix Please activate with a double click the field of your research project in the DynAge matrix of cooperation below. Tumors Cardio-Vascular Diseases Degenerative Diseases of the Musculoskeletal System Cognitive Disorders & Depression Societal Level Individual Level Molecular Level 6. Summary of the Proposal (limit of 300 words) Please summarize your research project. 2 (B) Outline of Project Proposal Please note the limitation of max. 3 pages for Section B. 1. Current Situation Put your project in the context of previously published empirical research from the general literature. Outline the novelty of your research question(s) from extant empirical research. How does your project address aging-related processes and/or contrast different phases of the life span? State your project’s value to advance current knowledge. 2. Own Previous Work Please list a maximum of three key publications per applicant. Please also list project-relevant third party-funding that has been attracted within the past 5 years, if applicable. 3. Aims/ Objectives What is the aim of the research project? How are different phases of the life span addressed? Provide the primary hypothesis of your study, or, if you work with qualitative methods please, provide the causalities that you expect to find within your study. 4. Work Plan How will the above objectives be achieved (a) during the DynAge funding period (01/16 to 12/16) and (b) beyond? 5. Sample Please provide a brief description of the planned sample(s) (including sample size), process of sample recruitment, inclusion and exclusion criteria. 6. Study Design E.g., study duration, number of assessments, type of design, description of intervention, … 7. Methods Which outcomes and independent variables will be analyzed? Which (statistical) procedures will be used for data analyses? If applicable, please, describe planned pilot work. Information on experiments/studies involving humans, human material, or animals. 3 8. Requested Funding from the Focus Area (max. 35.000,- EUR for projects involving members of two co-funding institutions; max. 52.000,- EUR for projects involving members of all three co-funding institutions. Co-funding institutions are FUB, CUB, and DIfE) Please present a brief financial plan for the requested DynAge funds. Please list types (staff and/or consumables) and amount of requested funding of both types separately for 2016 (i.e., Jan through Dec) and separately for each co-funding institution. Please list all requested funds in EUR. For example, your project group is composed of researchers from FUB and DIfE. The FUBresearcher plans to hire 3 student research assistants for one year, DIfE-researchers need about 17.000 EUR in consumables: Institution FUB Staff (EUR) 3 student research assistants for one year, à 41h/month: 18.000 EUR Consumables (EUR) Total sum (EUR) 18.000 Lab consumables: 17.000 17.000 35.000 Staff (EUR) Consumables (EUR) Total sum (EUR) CUB DIfE Sum (EUR) Your Project: Institution FUB CUB DIfE Sum (EUR) 9. Envisioned Goals in Attracting Third-party Funding Please illustrate your envisioned goals for attracting future third-party funding following potential funding by DynAge. 4 (C) General References (In addition to proposal authors’ key publications listed in Section B.2) 5 (D) Brief CVs of Participating Researchers <Please use one form per researcher> Role in consortium <Consortium PI, Consortium CoPI; Subproject PI; Subproject Co-PI; Coordinator, Investigator> Full title, full name Affiliation, department, division E-mail address Field of work <Discipline, subdiscipline (e.g., medicine, oncology)> Year of PhD/MD Career stage <R1: First Stage Researcher (up to PhD); R2: Recognized Researcher/PostDocs up to about 4 years following PhD; R3: Established Researcher/PostDocs from about 4 years following PhD (researchers who have developed a level of independence; Nachwuchsgruppenleiter, W1 Prof); R4: Leading Researcher (researchers leading their research area or field, W2/W3-Prof)> Publications 2010-2015 <peer-reviewed journal articles, books, book chapters> Number of times cited (please exclude citations of retracted publications) <Please use one of the following and indicate which one you used: Web of Science, Google Scholar, Scopus, Harzing’s Publish or Perish. E.g.: Web of Science: n times cited; Google Scholar: n times cited> Third-party funding 20102015 Title of Consortium: Consortium PIs: Title of Subproject: Own Role: Funding Agency: Funding Period: Amount own Subproject: Total Amount Consortium: /or/ Title of Project: Own Role: Funding Agency: Funding Period: Total amount: 6