AMERICAN LIVER FOUNDATION 2011 POSTDOCTORAL RESEARCH FELLOWSHIP AWARD APPLICATION Submit completed application electronically by October 15, 2010, 5 PM Eastern Time. American Liver Foundation 2011 Postdoctoral Research Fellowship Award OVERVIEW The American Liver Foundation (ALF) Postdoctoral Research Fellowship Award encourages the career development of individuals with research potential who require additional research training and experience. The award supports investigational work related to liver physiology and disease in order to prepare the recipient for a career in independent research. The Postdoctoral Research Fellowship Award is a one year award to supplement NIH or non-federal fellowship stipends and will not be awarded to an applicant who has no other source of research salary support. ELIGIBILITY Applicants must meet the following guidelines in order to be eligible for an ALF Postdoctoral Research Fellowship Award: 1. Applicant must be sponsored by a public or private non-profit institution accredited in the United States, Canada or Mexico engaged in health care and health-related research. 2. Applicant must be in his/her first or second year of his/her first Postdoctoral Research Fellowship at the time of application. Individuals with more than two years of postdoctoral research training are ineligible. 3. Applicant must be sponsored by a research mentor. 4. Applicant may apply for only one type of ALF award each year. TERMS OF AWARD AND REQUIREMENTS Funding 1. Funding is provided in the amount of $12,500 for one year. 2. Funding is a supplement to NIH or non-federal fellowship stipends. 3. Funding is provided directly to the applicant, not the institution. Institutional Requirements 1. Recipient is directly responsible to the sponsoring institution. 2. Award cannot be transferred to another mentor or institution without prior written approval from American Liver Foundation. 3. A maximum of one award will be made per mentor. 4. Recipient will promptly notify ALF regarding any change in his/her status or sponsored research. 5. Recipient will devote 50% or more of his/her time to the research project on which this application is based. Recipient may receive or provide research training and participate in teaching functions within the sponsoring institution, but may not undertake other substantial responsibilities during the award cycle. Publications It is required that ALF be acknowledged as “American Liver Foundation” in any presentations or publications resulting from research performed during the ALF Postdoctoral Research Fellowship Award cycle. Please forward an electronic copy or four (4) hard copies of each abstract, presentation, manuscript, publication and review to ALF. Reports At the conclusion of the award cycle the ALF Research Awards Program Final Scientific Report must be submitted to ALF by July 31. This report should consist of no more than two pages, written in lay language to the extent possible, and be signed by the mentor. It should contain a summary of the research performed during the award cycle, including actual results and their significance, as well as any pending or planned applications for additional research funding. 2 American Liver Foundation 2011 Postdoctoral Research Fellowship Award APPLICATION INSTRUCTIONS Do not exceed page limits and assemble the application in the order described below and listed under Checklist. Include separate, typed pages for all additional information using ½ inch margins and 11 point Arial font. Put your name (last name, first name) in the upper right-hand corner of each page and clearly label each piece of additional information. Convert your completed application into a single PDF file and submit it online by October 15, 2010 at 5 PM Eastern Time, according to the instructions at the end of this document. Applications that do not meet the requirements, in content or format, will not be reviewed. The application should contain the following sections. 1. Applicant Information – Fill in the information on page 4 of this application and use it as the face page for the application. 2. Summary and Abstract – Page 5 of this application must be used for the abstract. 3. Biographical Sketch – Provide a biographical sketch, including other support, using the current PHS 398 form for the applicant, mentor and any other key personnel. 4. Research Plan – Prepare in this order: Specific Aims, Background and Significance, Preliminary Results, Research Design and Methods, and References. This section is restricted to five pages. Results of unpublished observations may be summarized using text, tables or figures and they must be included in the five-page limit. The reference section is not included in the five-page limit. 5. Research Facilities – The research environment must be described, including laboratory space, if applicable, consultants and technical (including computer) resources. Limit to one page. 6. Institutional Review Board – All human studies require IRB approval. IRB approval for the proposed research project may be supplied with the application, or applied for at the time of application and verification of approval sent to ALF by January 14, 2011. If IRB approval is not necessary or not attached, please state why. Limit to one page. 7. Candidate’s Statement – Describe the benefits of this award to your research career and the impact the research mentor will have on your research development. Limit to one page. 8. Letters of Commitment from Department Head and Mentor – A letter must be provided from the head of the your department confirming that 50% of your time will be devoted to the research project on which this application is based. A letter of support from your mentor (if different from the department head) is also required, stating that he/she will be available to provide advice and guidance to you during the term of the award. Limit to one page each. 9. Letters of Recommendation – Two additional letters of recommendation attesting to your qualifications, commitment to research, and quality of scientific work must be submitted with the application. Limit to one page each. 10. Signatures – Page 6 of this application must be completed and signed by the appropriate individuals and included in the award application. 3 American Liver Foundation 2011 Postdoctoral Research Fellowship Award APPLICANT INFORMATION Please type Applicant’s Contact Information Name (last, first, middle initial) Institution Mailing Address (street, city, state, zip) Telephone Number Home Address Fax Number (street, city, state, zip) Email Address Telephone Number Start Date (month and year) of initial post-doctoral research position Current Position _______________________________________________________________________________ Mentor’s Name (include academic degree(s) Institution Mentor’s Address (street, city, state, zip) Telephone Number Fax Number Email Address Project Title Project Topic Related Disease(s) (If project is not applicable to any specific liver disease, please write unknown.) 4 American Liver Foundation 2011 Postdoctoral Research Fellowship Award SUMMARY AND ABSTRACT In the box below, provide a lay summary of your research project that describes how it is applicable to human liver disease. A B S T R AC T O F P R O P O S E D R E S E A R C H In the box below, briefly describe your research project, technical approach and anticipated results. 5 American Liver Foundation 2011 Postdoctoral Research Fellowship Award REQUIRED SIGNATURES The following is to be completed by a representative of the sponsoring institution who is authorized to certify the information below: Effective dates and amount of current Fellowship stipend (if any). ________________________ Source of stipend. _____________________________________________________________ Expected stipend for July 1, 2011 – June 30, 2012._______________________________________ Source of expected stipend. ______________________________________________________ List all sources of funding for which applications have been made. _____________________________ ________________________________________________________________________________ Signature ______________________________ Date_____________________ Title __________________________________ We have read and agree to the specific terms of the ALF Postdoctoral Research Fellowship Award. We attest that the applicant meets all eligibility criteria. Our signatures below indicate that the information in this application is accurate to the best of our knowledge. We understand that funding of the ALF Postdoctoral Research Fellowship Award will be paid directly to the applicant. Signature of Applicant Type full name and date Signature of Mentor Type full name and date ANIMAL EXPERIMENTATION A. Does your investigation involve the care and use of animals? Yes_______ No________ B. If the proposed study involves the care and use of animals, have the investigations been approved by the Animal Care and Use Committee of the applicant’s institution and do they follow the National Institutes of Health Guidelines on the care and use of laboratory animals? Yes_____ No_______ If the research involves the care and use of animals and the investigations have not yet been approved by the institutional Animal Care and Use Committee, then approval must be obtained and submitted to the ALF by January 14, 2011. 6 American Liver Foundation 2011 Postdoctoral Research Fellowship Award CHECKLIST Submit your completed application by October 15, 2010 at 5 PM Eastern Time. Applicant Information Summary and Abstract Biographical Sketches Research Plan Research Facilities Institutional Review Board Candidate’s Statement Letters of Commitment Letters of Recommendation Required Signatures APPLICATION SUBMISSION INSTRUCTIONS Submit completed application electronically by October 15, 2010, 5 PM Eastern Time. 1. Fill out this application completely and collect all necessary materials. Please assemble your application into a single PDF file which includes all letters of recommendation. 2. Follow the instructions on the Postdoctoral Fellowship Award webpage to upload your PDF file. 3. You will receive a confirmation email. 7