Section II A - Alberta Cancer Foundation

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CANCER RESEARCH FELLOWSHIP AWARD (POSTDOCTORAL and CLINICAL)
GUIDELINES & APPLICATION
SUBMISSION DEADLINE DATE: APRIL 1, 2013
DO NOT INCLUDE THIS SECTION WITH YOUR APPLICATION
The Alberta Cancer Foundation is pleased to offer the 2013 Alberta Cancer Foundation Postdoctoral and
Clinical Fellowship Awards to individuals who will be carrying out research related to cancer in Alberta.
TERMS AND CONDITIONS
Please reference the Alberta Cancer Foundation Guidelines and Terms and Conditions for Research
Program Investment document for complete terms and conditions for all Alberta Cancer Foundation
investments.
FUNDING CRITERIA
1.
Candidates must hold a Ph.D. or M.D. degree. Individuals wishing to undertake postdoctoral research
training in the same research environment (e.g. same department, sponsor or co-sponsor)
in which they received their Ph.D. are NOT eligible for an award.
2.
All candidates must have a sponsor who has a faculty appointment with an Alberta institution. Please
note that a maximum of two (2) applications per sponsor per competition is allowed.
3.
Sponsors may not substitute candidates for any Alberta Cancer Foundation Cancer Research
Fellowship Awards.
4.
Alberta Cancer Foundation Postdoctoral Fellowships and Clinical Fellowships will be awarded for a
three year term upon initial approval.
5.
The Alberta Cancer Foundation Cancer Research Fellowship Award provides:
a) for a Postdoctoral Fellowship: a stipend in the amount of $50,000 plus $5,000 research
allowance per annum payable for a three year term.
b) for a Clinical Fellowship: a stipend in the amount of $70,000 plus $5,000 research allowance
per annum payable for a three year term.
6.
Petro-Canada Young Innovator Award will provide a $5,000 research allowance to a top ranking
fellow in cancer research. (Suncor Energy is the proud owner of Petro-Canada)
7.
Dr. Mervin Laskin Fellowship Award will be offered to a top ranking application from a radiation
oncology resident at the Cross Cancer Institute, Edmonton. This Fellowship is offered on a rotating
basis with the Bures T. Laskin Fellowship and Dr. Michael J Hutchison Fellowship.
8.
Dr. Anthony Fields Clinical Fellowship Award for the top ranked application from a clinical fellow.
9.
Roche Fellowship in Translational Cancer Research Award will be offered to a top ranking fellow
in translational cancer research and will receive $1,500 research travel allowance in addition to the
normal fellowship award.
10.
Fred C. Coles Cancer Research Fellowship Award will be offered to the top ranking fellow who will
be carrying out research related to cancer at the Tom Baker Cancer Centre and/or Southern Alberta
Cancer Research Institute at the University of Calgary.
11. In the event a fellow is offered multiple awards, the fellow is encouraged to accept the non-Alberta
Cancer Foundation award. The Alberta Cancer Foundation will provide a supplement to the external
award up to the value of the Alberta Cancer Foundation award.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
REVIEW CRITERIA
Proposals from this funding program will be reviewed by the Alberta Cancer Foundation Training Award
Review Committee. Each application is reviewed by assigned committee members. All applications
are generally reviewed on the following criteria:
1.
Performance: Candidate’s Publication Records, Grades, and Awards
a)
Publications will be evaluated on the rate of productivity and quality of journal.
b)
Candidate’s transcripts will be evaluated for academic performance.
2.
Research Project
a)
Relevance to cancer.
b)
Project Design: immediate objective; methods employed; estimated timeline; and
expected outcomes/future plans.
c)
Project Budget: approved budget that supports the project.
d)
Summary of supporting project and preliminary data.
3.
Project’s Support Structure
a)
Sponsor’s publication productivity.
b)
Laboratory Environment: location and description of designated space; shared facility
and equipment availability.
4.
Candidate Support
a)
Reference letters will be evaluated on the evidence of strengths of the candidate.
(Please have your referees comment on your academic achievement in the letter.)
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
SUBMISSION CHECKLIST
Please utilize the following checklist to assist you in submitting a complete proposal. If a section of the
application form is not applicable to the proposed research please include and mark section N/A.
Incomplete applications will be deemed ineligible and returned to the proposed supervisor.
Cancer Research Fellowship Application:
Application Cover Page – Applicant Information
Section
A
Co-Sponsor Information
Section
B
Outline of Proposed Research – 3 Pages Maximum
Section
C
Project Renewal (if applicable)
Section
D
Project Summaries
Email summaries to programinvestment@albertacancerfoundation.ca (Word format only)
Please note: the e-mail subject line should be: <last name of supervisor.last name of candidate post
doc application summary 2013> (e.g., <Smith.Brown postdoctoral application summary 2013> or
<Smith.Brown clinical application summary 2013>)
Section
E
Research Environment
Section
F
Budget & Budget Justification
Section
G1&2 Personal Data & Publications
Section
H
Reprints & Preprints
Section
I
References Letters (attached in sealed envelopes & signed across seal by
referee)
Section
J
Transcripts (official or certified true copies)
Section
K
Patient Consent Forms & Protocols
Section
L
Research Classification
1 single-sided original hard copy of the completed application has been submitted with
transcripts and letters of reference attached individually in sealed signed envelopes, to the
address below for delivery no later than close of business on the competition deadline date
of April 1, 2013.
Please forward 1 single-sided original hardcopy to:
Alberta Cancer Foundation
Program Investment
Holy Cross Site
613, 2210 - 2 Street SW
Calgary, Alberta T2S 3C3
NOTE: Should require proof of delivery, please forward your complete application using the appropriate
courier service. Due to volume, it will not be possible to respond to inquiries pertaining to receipt of
application, references or transcripts.
If you have any questions, please contact Program Investment at
programinvestment@albertacancerfoundation.ca or call 403 476 2423
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
DEADLINE: APRIL 1, 2013
For ACF Use Only:
Competition #:
File #:
CANCER RESEARCH FELLOWSHIP FUNDING APPLICATION
POST-DOCTORAL
CLINICAL
Title of Project:
Sponsor:
Title:
Dr. Prof.
Institution:
Surname:
Mr.
Mrs.
Department:
Street Address:
Telephone:
Ext:
(
)
Candidate:
Title:
Dr. Mr. Mrs. Ms.
Institution:
First Name:
Middle Initial:
Ms.
Academic Position:
City:
Prov:
Email:
Country:
Postal Code:
Surname:
First Name:
Middle Initial:
Department:
Street Address:
City:
Prov:
Country:
Postal Code:
Telephone:
Ext:
Email:
Gender:
(
)
M
F
Citizen of :
Immigrant Status in Canada:
Canadian
Student Visa
Permanent Resident
Working
Funds to be administeredVisa
by: (Choose one only)
Proposed Start
(dd/mm/yy):
/ /
University of Alberta
University of Calgary
University of Lethbridge
Are you receiving funding /income from any other
Number of years post-PhD:
source?
No
Yes
If Yes, FundingThe
Term
(dd/mm/yy):
- accept,
/ / the terms and conditions governing Alberta
Signatures:
undersigned
agree/ to,/ and
Cancer Foundation Terms and Conditions for Program Investments located at www.albertacancer.ca.
Signature of:
Printed Name:
Candidate:
Sponsor:
Dept. Head/Chair:
Faculty Dean:
Research Services/Finance Office of University:
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Date: (dd/mm/yy)
PI Name / Project Title
SECTION A – CO-SPONSOR INFORMATION
Provide the following information for all individuals involved with this application.
NOTE: Sponsors signing below acknowledge that the candidate has been offered a secured position
within the sponsor’s lab.
Co-Sponsor (if applicable):
Title:
Dr. Prof. Mr. Mrs. Ms.
Institution:
Surname:
Given Name:
Department:
Street Address:
City:
Middle
Initial:
Academic Position:
Prov.:
Country:
Telephone:
Ext:
Email:
Postal Code:
(
)
I hereby acknowledge my involvement on this grant and that all information provided at the time of
submission is accurate to the best of my knowledge.
__________________________________
Signature
______________________
Date (mm/dd/yy)
May 1, 2013Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Page 5
PI Name / Project Title
SECTION B – OUTLINE OF PROPOSED RESEARCH
Please append to this page your outline of the proposed cancer research. This section should be
formatted and collated as follows:
 The proposal should be no longer than 3 pages.
 An additional 2 pages for supporting tables and figures may be appended.
 A list of references should include the names of all authors, the full title, and the full journal
citation. It should also be single spaced and is excluded from the page limit.
 Any associated consent forms and protocols may be attached in Section K.
Formatting: No more than 49 lines per page including titles and spaces. Margins must be no less
than 0.75 inches. Text must be single spaced, 12 point, Arial font. Page reduction is not allowed.
Please note: If this project is translational in nature, please include within the summary a
description of the nature of this translation. Also, please ensure to classify the application as
Translational Research in Section L of this application. Please refer to the Alberta Cancer
Foundation Guidelines for Research Program Investment document for definitions of
Translational Research.
May 1, 2013Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Page 6
Sponsor Name / Candidate Name
SECTION C - PROJECT RENEWAL
If this is a RENEWAL application, please outline your progress to date in the space below.
(Formatting: margins must be no less than 0.75 inches; text must be single spaced, 12 point, Arial font.
Page reduction is not allowed)
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION D – PROJECT SUMMARIES
Please email the following project summaries page to programinvestment@albertacancerfoundation.ca
in Word format. Alternatively, the text may also be posted into the body of the email. Do not send in
Adobe PDF format. These summaries may be shared with external agencies and the public. Please be
cognizant of any intellectual property issues or other sensitivities.
NON-TECHNICAL SUMMARY
The Alberta Cancer Foundation is accountable to its donors for the investments it makes in research.
Please provide a summary, in simple, non-technical language, which explains the rationale of the
investigation, the relevance to cancer how this would impact those at risk of cancer, those diagnosed
with cancer and/or cancer survivors. Limit to the space provided.
CASE FOR SUPPORT
Expanding on the above summary, describe why a prospective donor should consider supporting this
project. Include tangible benefits the proposed initiatives have for students, faculty, staff, patients,
Alberta, Canada and beyond. Describe the benefits of this project to the donor. Limit to the space
provided.
SCIENTIFIC, INCLUDING RELEVANCE TO CANCER
Describe the objective of the proposed research and its relevance to cancer. Limit to the space
provided.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION E - RESEARCH ENVIRONMENT
RESEARCH FACILITIES
In the space provided, describe briefly the amount and location of laboratory space, the special
equipment, and the shared facilities which can be provided by the sponsor.
RESEARCH INTERACTIONS
In the space provided and where applicable, briefly indicate the colleagues and research programs to
which the candidate would be associated and the nature of this association.
OTHER RESPONSIBILITIES
In the space provided, indicate the nature and the extent (hours per year) of non-research activities.
a) Teaching (including undergraduate student supervision):
b) Administrative duties:
c) Clinical work:
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION F - BUDGET & BUDGET JUSTIFICATION
Is funding in place to support this project?
Yes
No
If yes, attach copies of the approved budget and research summary page of the grant supporting this
project.
If no, please provide details as to how the project will be supported in the space below.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION G1 - PERSONAL DATA & PUBLICATIONS (SPONSOR)
Please complete the table below for the Sponsor OR append the following CIHR Common CV sections
only: Expertise and Discipline; Academic Background; Work Experience; and Distinctions /
Awards/Credentials. If the Sponsor is not currently utilizing a CIHR Common CV, use the Education
and Research Training and Academic or Clinical Positions Held sections below. For your reference, the
Common CV module is located at www.commoncv.net . Please number all pages appropriately.
Name:
Education and Research Training
Month/Year
Degree
University/Institution
Scientific
Field/Discipline
/
/
/
/
Academic or Clinical Positions Held
Month/Year
/
Position University/Institution
Department
/
/
/
/
If there has been a break in education/training or academic history, for example a maternity leave,
please indicate so in the above table and provide an explanation below:
Publications
Please indicate your total lifetime number of publications to date (excluding abstracts):
Please indicate the number of publications in the last 5 years(excluding abstracts):
Append to this page a list of papers published during the past five years. Title must be provided.
Include papers accepted for publication. Do not include manuscripts or abstracts in preparation.
Please number the pages appropriately.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION G2 - PERSONAL DATA & PUBLICATIONS (CANDIDATE)
Please complete the table below for the Candidate by appending the following CIHR Common CV
sections only: Expertise and Discipline; Academic Background; Work Experience; and
Distinctions/Awards/Credentials. If the candidate is not currently utilizing a CIHR Common CV, use the
Education and Research Training and Academic Research and Work Experience and Academic
Achievements sections below. For your reference, the Common CV module is located at
www.commoncv.net .
Name of Candidate:
Education and Research Training
Month/Year
/
Degree
University/Institution
Scientific Field/Discipline
University/Institution
Department
/
/
/
/
Academic Research and Work Experience
Month/Year
/
Position
/
/
/
Academic Achievements (Prizes, Honors & Awards held by the candidate)
Month/Year
/
Prize/Honor/Award Held
University/Institution
Department
/
/
If there has been a break in education/training or academic history, for example a maternity leave,
please indicate so in the above table and provide an explanation here.
Publications
Please indicate your total number of publications to date (excluding abstracts):
Please indicate the number of publications published or in press in the last 5 years (excluding
abstracts):
Append to this page a list of papers published or in press during the past five years. Title must be
provided. Include papers accepted for publication. Do not include manuscripts or abstracts in
preparation.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION H - REPRINTS & PREPRINTS
You may append to this page, the abstract cover page for up to three (3) publications. Do not append
the full publications.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION I – REFERENCE LETTERS & SUPPORT
REFERENCE LETTERS
List of References: List the three (3) individuals (other than the sponsor of this application) who have
been contacted to provide letters of reference of academic nature for this application. Please have
your referees comment on your academic achievement in the letter.
All reference letters must be personally sealed and secured by the referee and can be forwarded
either by;
1) referee signed and sealed envelope attached to the application
2) referee sent email with letters attached in PDF format to
programinvestment@albertacancerfoundation.ca . If your referee is sending the letter via an
e-mail the subject line should be: <last name of referee.last name of candidate post doc
application reference letter 2013> (e.g., Smith.Brown postdoctoral application reference
letter 2013. Or Smith.Brown clinical application reference letter 2013). Please
communicate this with your referees.
Name
Relationship with Candidate
Attached?
Yes
To follow
Yes
To follow
Yes
To follow
LETTER OF SUPPORT FROM SPONSOR
The sponsor must provide a letter to acknowledge support of the candidate within the designated
department supervisor’s/sponsor’s lab.
SECTION J - TRANSCRIPTS
Append to this page an official copy of all of the candidate’s academic transcripts. These transcripts
must be in the original sealed envelopes from the educational institute. If official transcripts from
foreign institutions are difficult to obtain, copies certified as true copies by an Alberta University
department head or research services office may be provided. Official translated versions of
transcripts, or certified true copies should be appended if applicable.
SECTION K - PATIENT CONSENT FORMS & PROTOCOLS
If consent from patient/parent/guardian is required, attach copy of consent form to be used to this
page. If the project includes a clinical protocol, also include it in this Section. Please note that if your
application requires a consent form and/or protocol, it is not to be regarded as a supplement to the
outline of proposed research and should be considered as reference material only.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
Sponsor Name / Candidate Name
SECTION L - RESEARCH CLASSIFICATION
Please check one or more boxes in each section which best describes your research project. All
sections must be completed unless otherwise indicated. This information is being collected for
administrative purposes to aid in reporting the types of research funded by the Alberta Cancer
Foundation.
Section I
SCIENTIFIC DISCIPLINE(S)
BIOLOGICAL SCIENCES
Biochemistry
Cell Biology
Developmental Biology
Endocrinology
Genetics
Immunology
Molecular Biology
Virology
Other (Please Specify)
CHEMICAL SCIENCES
Carcinogenesis
Cytotoxic Drugs
Other (Please Specify)
PHYSICAL SCIENCES
Imaging
Molecular Structure
Photobiology
Radiobiology
Other (Please Specify)
CLINICAL SCIENCES
Drugs/Chemotherapy
Diagnostic Imaging
Nursing
Pathology
Psychiatry/Psychology
Radiation Oncology
Rehabilitation Medicine
Surgery
Other (Please Specify)
POPULATION HEALTH SCIENCES
Behavioural Sciences
Community Health
Epidemiology
Mathematical Modeling/Database
Occupational/Environmental
Health
Other (Please Specify)
Section II A
CATEGORY OF RESEARCH
Basic Research
Clinical Research
Intervention Research
Program Delivery
Surveillance and Monitoring
Translational Research
Section IIB
(Fill in ONLY if you checked Intervention
Research in Section II)
TYPE OF INTERVENTION RESEARCH
(Check ONE OR MORE which apply)
Diagnosis
Organization/System
Palliation
Policy
Prevention
Rehabilitation
Screening
Treatment
Other (Please Specify)
Section III
(Fill in ONLY if sponsor/supervisor is an
Alberta Health Services (AHS) Cancer Care
tumour
group member)
AHS
CANCER
CARE TUMOUR GROUP
Breast
Cutaneous
Endocrine
Gastro-Intestinal
GU
Gynecology
Head & Neck
Hematology, Lymphoma
Lung
Melanoma
Musculoskeletal, Sarcoma
Neuro-Oncology
Palliative
Pediatric
Uro-Oncology
Other (Please Specify)
Section IV
CANCER SITE
All
Alimentary Tract (except Colon/Rectum)
Bladder
Brain/Neurological
Breast
Colon/Rectum
Endocrine (include Pituitary, Thyroid,
Adrenal)
Head and Neck
Hematopoietic (Leukemia, Lymphoma)
Kidney
Liver
Lung
Musculoskeletal
Ovary
Pancreas
Pediatric
Prostate
Skin/Integument (include Melanoma)
Testes
Uterus
Section V
CCRA CLASSIFICATION
EPIDEMIOLOGY
Ecological/environmental/correlation
Cross-sectional/prevalence
Case-control
Prospective cohort
Historical cohort
BASIC/FUNDAMENTAL
Pure/in vitro
Pure/laboratory animals
Basic cancer biomedical research/in vitro
Basic cancer biomedical research/laboratory
animals
Basic cancer biomedical research/human
tissue
CLINICAL/DEVELOPMENTAL
Experimental medicine
Drug/procedure development
Early phase trials (no randomization)
Randomized controlled trials
Health education/promotion
EVALUATIVE/APPLIED
Program/service/intervention evaluation
Policy evaluation
Health economics
Ethics
Participatory action research
METHODOLOGICAL
Statistical methodology/biostatistical
Behavioral and social sciences
Novel applications
Research synthesis
KEYWORDS
Section VI to best describe your research:
1.
2.
3.
4.
April 1, 2013 Alberta Cancer Foundation Postdoctoral and Clinical Fellowship Awards
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