BMRC – SERC Joint Diagnostics Grant Call 2011 CONFIDENTIAL AGENCY FOR SCIENCE, TECHNOLOGY & RESEARCH DIAGNOSTICS GRANT CALL 2011 A Joint Initiative by Biomedical Research Council (BMRC) & Science and Engineering Research Council (SERC) Pre-Proposal Submission <To Insert Descriptive Title of the Project> SUBMITTED BY: Lead Clinical Co-Principal Investigator <To insert Name of Lead Clinical CoPrincipal Investigator> <Designation, department, Host Institution> Lead Technical Co-Principal Investigator <To insert Name of Lead Technical CoPrincipal Investigator> <Designation, department, Host Institution> To add and insert if there are more than 2 co-PIs (A*STAR and/or NonA*STAR Co-PIs Pre-Proposal Number*: Submission Date* : * To be completed by the A*STAR office CLOSING DATE: 15 June 2011 (Friday) at 5pm, SST May 2011 Page 1 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 SUBMISSION DETAILS IMPORTANT: EVERY SECTION AND FIELD MUST BE COMPLETED. PLEASE INDICATE ‘NA’ WHERE A PARTICULAR SECTION OR FIELD IS NOT APPLICABLE. INCOMPLETE APPLICATIONS WILL BE REJECTED. Softcopy submission must comprise the Word document (without signatures) and the PDF format (with Co-PIs’ signatures and Host Institutions’ signatures) and have to be submitted to: rachel_wee@a-star.edu.sg with the subject header “BMRC – SERC Joint Diagnostics Grant Call submission 2011”. All applications (softcopy and hardcopy) must be submitted by 15 June 2011 (Friday) at 5pm, SST All hardcopy forms with signatures must be submitted through either the Lead Clinical Co-PI’s or Lead Technical Co-PI’s respective Office of Research / Principal’s or Directors’ Office / Agency Headquarters / RI ED’s Office / Institutes or equivalent. Address for hardcopy submission: Agency for Science, Technology and Research Biomedical Research Council 20 Biopolis Way, #08-01, Centros Singapore 138668 Attn: Ms. Rachel Wee For further enquiries, please feel free to email: Ms Koh Hui Shan at: koh_hui_shan@a-star.edu.sg OR Ms Crispina Tay at: tayybc@scei.a-star.edu.sg May 2011 Page 2 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 INSTRUCTIONS The originators of the Pre-Proposal are encouraged to concisely articulate Sections A – E in the boxes provided for each section, using Arial font size 10, SINGLE spacing for your text. Please do not extend of the size of the boxes provided. SECTION DESCRIPTION A. Research Proposal B. Grant Support C. Curriculum Vitae D. Declaration By Co-Principal Investigators And Endorsement By Host Institutions Appendix for References E. The following serves as a general guideline you may want to refer to in completing Part A of the pre-proposal application form CLINICAL NEED Background of Problem: What is the problem observed? Why is this a problem that warrants significant attention? Treatment options: What are the current treatment options? What are the shortcomings of the current treatment options? Define unmet need: What is needed to address the problem and/or treatment gap identified above? Market Size: Who is/are the target patients? What is the incidence and/or prevalence? What is the total amount spent per year to address the problem faced by these target patients? POTENTIAL TECHNOLOGICAL SOLUTION Solution Overview: Provide an Overview of the solution Technology: Provide a summary of the core technology and how it works. Competitive Analysis: How is the proposed solution better than existing/emerging competing technologies? Include necessary references (in Appendix) POTENTIAL IMPACT OF SOLUTION Value Proposition: How does the proposed solution benefit various stakeholders (patients, physicians, payers)? This can be from both clinical and economical perspectives. AIMS OF PROJECT, OVERVIEW OF METHODS AND THE TEAM Aims of project: List briefly the key aims/objectives of the project Overview of Methods: Provide an overview of the methods that will be employed The Team: plans for interaction among the team member(s) andachieving the research objectives May 2011 Page 3 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 A. PROPOSED RESEARCH PROJECT Print information using Arial Font 10, single-spaced and within the given area. Do not exceed 2 pages. May 2011 Page 4 of 10 CONFIDENTIAL May 2011 BMRC – SERC Joint Diagnostics Grant Call 2011 Page 5 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 B. GRANT SUPPORT Provide the details for all currently held or applied grants by the Lead Co-PIs and Co-PIs. These include those supported by / applied to A*STAR, NMRC, NRF,Universities, Clusters and other public funding agencies. Title of Research Funding Agency Amount of Fund Approved/ Balance Received Available ($) ($) Support Period (Year) Expiry Date of the grant C. CURRICULUM VITAE In no more than 1 page provide the following information on each CoPrincipal Investigator: Name Current position and past employment history (Please provide full details, eg, joint appointments, percentage of time spent in Singapore every year, if applicable) Academic qualifications (indicate institution’s name and year degree awarded) Latest 10 publications Patents held (related or unrelated to study) Recent awards (Scientific awards) Research outcomes from other grants (e.g. publications, patents, awards, etc.) May 2011 Page 6 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 D. DECLARATION AND ENDORSEMENT We declare that the facts stated in this application and the accompanying information are true and that this is an original and latest version of the PreProposal. *Lead Co-PIs and Co-PIs from any of the A*STAR institution will require endorsement by Executive Direction of the host institution to verify official affiliation. Lead Clinical Co-Principal Investigator Name Signature Date Endorsement by the Host Institution (Executive Director) of the Lead Clinical Co-Principal Investigator: Name: Designation : Signature: Date : I, ______________________________________(Executive Director of Host institution), declare that the applicant has an official affiliation our the institution. May 2011 Page 7 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 Lead Technical Co-Principal Investigator Name Signature Date Endorsement by the Host Institution of the Lead Technical Co-Principal Investigator: Name: Designation : Date : Signature: I, ______________________________________(Executive Director of Host institution), declare that the applicant has an official affiliation to the institution. Other Co-Principal Investigators (add in additional rows if necessary) Name Signature Date Endorsement by the Host Institution of the Co-Principal Investigator: Name: Designation : Signature: Date : I, ______________________________________(Executive Director of Host institution), declare that the applicant has an official affiliation to the institution. May 2011 Page 8 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 Other Collaborators (no signature required) Name Institution/Department Key participants from other publicly funded institutions e.g. universities/hospitals (add in additional rows if necessary) Note: Collaborators do not receive funding May 2011 Page 9 of 10 CONFIDENTIAL BMRC – SERC Joint Diagnostics Grant Call 2011 E. APPENDIX FOR REFERENCES Include only necessary references May 2011 Page 10 of 10