Application Form - Freie Universität Berlin

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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)
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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.
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(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:
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