Application Form - Osteoporosis Australia

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Osteoporosis Australia Expression of Interest (EOI) Application
This EOI is an application to obtain a Performance Health Systems BioDensity machine
(‘equipment’) for the purposes of research only. The completed application must be
submitted to Osteoporosis Australia.
Please note:
 The equipment will be made available only until the project is complete (or the
project no longer requires it)
 The equipment is intended to support research based in an Australian institution
 EOI submissions will be reviewed by an expert panel from Osteoporosis Australia
 EOIs must meet both applicant and project eligibility criteria to be considered for
support
 The EOI must be submitted by 5:00pm, 18 November 2015. Late applications will
not be accepted.
 The EOI is for the equipment only. No other project support is offered.
APPLICANT ELIGIBILITY
Applicants to this EOI must:
 Be employed by a university, hospital or academic research institution based in Australia
 Have a recognised research or medical qualification
PROJECT ELIGIBILITY
The projects outlined in your EOI must utilise the BioDensity equipment and fulfil at least one of the
following broad objectives:


Evaluate the role of exercise in bone health in Australia
AND/OR
Advance the prevention, diagnosis and/or management of patients with osteoporosis or
low bone density
SUBMISSION & ASSESSMENT
EOI Submission
The application form must be completed in full. Please answer all questions accurately, observing
word count requirements. Completed applications must be submitted by email by 5:00pm 18
November 2015. Osteoporosis Australia welcomes preliminary enquiries by telephone (02 951
88140) or email (research@osteoporosis.org.au). Applications submitted after the closing date will
not be accepted.
Assessment
The Expert Panel will assess:
 The novelty and importance of the project
 The feasibility of the project
 The track record of the investigator and his/her capacity to deliver proposed project
outcomes
 Whether the project is likely to achieve its proposed outcomes
 Likelihood of publication
 Potential for patient benefit
Notification of Award
Successful applicant(s) will be advised by telephone within 24 hours of the funding decision being
made. Both successful and unsuccessful applicants will be officially advised by letter within one week
of the funding decision. No further discussion regarding the award outcomes will be entered into.
The award(s) will be formally announced on the Osteoporosis Australia website.
APPLICATION FORM
All fields must be completed. Please answer each question accurately, observing word count limits.
Ethical and other approvals (where appropriate) must be submitted with the completed application.
If you have any questions about the submission process, please contact Osteoporosis Australia
(02 9518 8140 OR research@osteoporosis.org.au).
Email your completed application to: research@osteoporosis.org.au
Closing date: 18 November 2015. Applications submitted after the deadline will not be accepted.
DATE
Name and Title
Applicant details
Current position
Email
Preferred phone number
Medical and/or Research qualifications (list all)
Year that last qualification was awarded
Organisation name and department
Organisation address
Please list any conflict of interest
How did you learn about this EOI?
Name and title
Current position
Co-investigator details
Organisation and department
Medical and/or research qualifications
Role in this project
Name and title
Organisation and department
Current position
Medical and/or research qualifications
Role in this project
Project details
Project Title
Expected project start date
Expected project duration
Provide a brief overview of the project aim, method and expected outcomes (250-350 words)
Briefly describe the novel aspects of your project (maximum 100 words)
Briefly outline your experience in this area of research (maximum 100 words)
Outline your publication plans for this research.
(maximum 50 words)
How will the outcomes of this project be further developed and/or translated into clinical practice?
(maximum 100 words)
Outline your institution’s ethics requirements for this project and expected timelines.
(A few sentences only).
Please confirm if your institution has suitable public liability insurance for using equipment in research.
YES / NO
Budget
Project total budget
Income sources (confirmed and pending)
Lay summary
The lay (non-technical) summary will be used to explain your project to the media and the general
public. The summary should ‘tell the story’ of your project to those with no detailed medical or
scientific knowledge. Avoid technical terms or scientific jargon. If technical terminology is
unavoidable, a brief explanation in plain language should be given.
Proposed Lay title of project
Describe what you will be doing during your project
Maximum 50 words
In what ways will the outcomes of the project benefit bone health in general or people with
osteoporosis?
Maximum 50 words
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