SSHRB APPLICATION FORM
WESTERN STRATEGIC SUPPORT FOR SSHRC SUCCESS
Applicant & Project Information
Principal Investigator:
Name:
Extension:
Email:
Department or School:
Faculty:
Rank (e.g. Prof., Associate Prof., Assistant Prof., etc.):
Status (e.g. Limited Term, Tenure-Track, Tenure, etc.):
Date of 1st Appointment at Western:
Do you meet Early Career Researcher criteria?
Yes
(< 3 years in research appointment)
Co-Investigators:
Name
Rank
No
Affiliation
Signature
Project Information:
Title of Project:
Total Amount Requested:
ROLA Proposal ID:
Funding Priority Applying for:
(Seed or Bridge Grant)
SSHRC Grant Applying for:
(within 2 years, if awarded)
Proposal Summary:
Within the 1 page parameter of the next page, provide a summary explaining: a) Why this project qualifies for internal funding; b) how it
supports your long-term research plans; c) feedback received from a SSHRC submission and if your external submission was previously peer
reviewed; and d) the external SSHRC competition you plan to seek support from. Include as appropriate:

Recent progress

Short- and long-term objectives

Literature review

Methodology

Plans for support and development of HQP

Anticipated impact of the research
An additional page of references or images may be attached at the end of the application.
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Budget
Salaries and Benefits
e.g. Technician
Postdoctoral Fellow
Graduate Student
Additional Details
Materials and supplies
Amount
$0.00
$0.00
$0.00
$0.00
$0.00
Travel (in accordance with Western Policies)
$0.00
$0.00
Dissemination (publication costs, workshops, etc.)
$0.00
$0.00
Equipment
$0.00
$0.00
Equipment and computing needs are eligible for support only if critical to the research
goals and the need is clearly documented. Equipment purchased with SSHRB funds
remains the property of the University as per Western's policy with respect to ownership
and disposition of equipment.
$0.00
$0.00
$0.00
$0.00
Other Expenses (specify):
Total Amount Requested:
$0.00
The maximum allowable request is $25,000 (Seed and Bridge).
Budget Justification:
Abbreviated CV Summary
Funding Sources:
Surname and initial(s) of
principal investigator and coinvestigators (include lead
institute where grant held if
not at Western University):
Project title OR Conference name, year, and
location:
Project period start and end date:
Funding agency and
program name:
Type of support
requested (i.e.
research,
strategic,
equipment, etc.):
Funds
requested
and funds
received:
Status (i.e.
awarded,
denied,
pending):
a) Support held in the past 5 years, but now complete:
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b) Support currently holding:
c) Support applied for (pending and denied):
Student Supervision and HQP Training:
a)
List names of, and degrees sought by, graduate students currently supervised directly by the applicant(s).
b)
List names of, and degrees conferred on, graduate students who worked under the direct supervision of the applicant(s) during the last
five years.
c)
Where undergraduate students exceed 5, a list will be accepted as a separate attachment.
Currently
Supervised
Over the past five years
(excluding the current year)
Co-supervised
Supervised
Co-supervised
Total Number
Undergraduate
Master’s
Doctoral
Postdoctoral
Others
Total Number
Publications:
List publications by applicant (with bibliographic references) for the last five years. Alternatively, or in addition, applicants may list creative
works, exhibitions, performances, or other evidence of practice of professional skills, with dates and brief explanation. Please ensure all author
names are clearly indicated, in the correct order, on each publication listing.
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Equivalent External Grant (EEG) Details – if Co-PI or Co-Applicant (with signatories on EEG)
Complete this section if seeking Bridge funding under the EEG eligibility criteria.
Project Title of EEG:
PI on EEG:
ROLA Proposal and/or
Award ID of EEG:
Grant Period of EEG:
% of responsibilities on EEG as
Co-PI or Co-Applicant:
Total EEG Award and portion of
funds used as Co-PI or CoApplicant:
Summary of responsibilities on
EEG as Co-PI or Co-Applicant:
Briefly summarize how your EEG
research work as Co-PI or CoApplicant relates to your
proposed research:
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SSHRB Application Signatures
All signatures provided below indicate knowledge of and adherence to the terms of reference and guidelines as posted on the Western
Strategic Support for SSHRC Success website.
Applicant’s Name & Signature
Date
Chair’s Name & Signature
Date
Dean’s Name & Signature
Date
By signing above, the Faculty supports this application and agrees to provide the required matching funds as stipulated by SSHRB
Terms of Reference, should this application be successful.
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