CATALYST GRANT
COMPETITION 2015
APPLICATION WORKSHEET
Use this worksheet to compose your responses to the application questions before uploading them to
the Research Portal. Composing with Word will autosave your work, and will allow you to spellcheck and
ensure your responses are within the word limit.
1) Project Summary:
1.1) * Lay Summary: In plain English, describe the proposed activities and outcomes. This summary
should be suitable for publication or press release, and understandable by a general audience.
See this tip sheet on how to write effective summaries. This response should be no longer than
200 words.
1.2) * CIHR Pillars: Indicate which of the four Canadian Institutes of Health Research (CIHR) pillars of
health research your proposed activities fall under. If more than one applies, select the primary
area only. For definitions of each pillar, see CIHR's glossary: http://www.cihrirsc.gc.ca/e/34190.html#r
 Biomedical research
 Clinical research
 Health services research
 Social, cultural, environmental, and public health research
1.3) * Priority Areas: Indicate which of the three Research and Capacity Building priority areas the
proposed activities will address. Select all that apply.
 Aboriginal Health
 Mental Health and Substance Use
 Seniors Health
 Other
1.4) * Service Plan Goals: Indicate which of the following three Island Health goals your proposed
activities will address. Select all that apply. View the Island Health Service Plan for detailed
objectives within each goal.
 Support the health and wellbeing of British Columbians
 Deliver a system of responsive and effective health care services across BC
 Ensure value for money
CATALYST GRANT
COMPETITION 2015
1.5) * Region: Indicate where the proposed activities will take place. Select all that apply.
 Geography 1
 Geography 2
 Geography 3
 Geography 4
For a map of Island Health’s geographic regions, see this overview.
1.6) * Identify and explain the roles of all Island Health sites and departments involved in the
proposed activities. If applicable, identify and justify any sites other than Island Health.
1.7) * Do the proposed activities include collaborative opportunities? Check all that apply:
 Collaboration with community partners
 Collaboration with academic partners
 Collaboration with patient partners or groups
 Other
1.8) * Potential Reviewers: Please provide the names and institutional affiliations of at least two
experts in your field who would be qualified to evaluate this application. You are not required
to contact potential reviewers. These suggestions cannot be in any potential or actual conflict
of interest with any member of the project team. Applicants are also requested to identify
anyone NOT eligible to act as a reviewer due to a conflict of interest. Examples of potential or
actual conflicts of interest include people who:
 Have collaborated, published or been a co-applicant within the last five years with
the co-leads named in a project.
 Have been a student or supervisor within the last 10 years.
 Are or has been a close personal friend or relative.
 Have a long-standing or serious scientific or personal difference with team
members.
2) Required Attachments: The following attachments must be uploaded to the Research Portal.
1. Activity Description: Describe the planning activities and grant applications you will undertake
with this funding and within the term of the award. In addition to ensuring that all evaluation
criteria are addressed, include:
a) Personnel: identify and justify by role the proposed team members you would bring on using
this funding, if applicable (e.g., grant-writer, health economist, statistician).
CATALYST GRANT
COMPETITION 2015
b) External Grant Applications: identify the grant opportunity(ies) for which you will apply using
this award. Indicate deadline, amount, funding agency, competition and/or agency objectives,
and anticipated notification of award. At least one external grant opportunity must be
identified.
 FORMAT: PDF
 PAGE LIMIT: 4 pages maximum (not including references)
 TEMPLATE AVAILABLE: no
2. Timeline of Activities and Deliverables: Provide a timeline that clearly indicates activities and
deliverables by quarter or by month. The timeline must not exceed the term of the award.
 FORMAT: PDF
 PAGE LIMIT: 2 pages maximum
 TEMPLATE AVAILABLE: no
3. Budget Spreadsheet: List the eligible costs for which you plan to use this award. Include
estimated amounts for each category. Describe roles and include hours if funding will be used
for personnel. Proposed budget request must not exceed $25,000 inclusive of taxes and
benefits. If the planned external grant application(s) require a Letter of Intent (or equivalent)
prior to invitation to submit full application, up to $3,000.00 may be applied to that component.
*Note: budget proposals for successful applicants will be rounded to the nearest $100 for
disbursement of funds.
 FORMAT: Excel spreadsheet
 PAGE LIMIT: one sheet
 TEMPLATE AVAILABLE: Yes. Download here (Excel).
4.
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Budget Justification: Include a written justification for budgeted items.
FORMAT: PDF
PAGE LIMIT: no limit
TEMPLATE AVAILABLE: no
5.
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CVs: Include CVs for all listed team members.
FORMAT: PDF
PAGE LIMIT: none
TEMPLATE AVAILABLE: Yes. Download here (Word format; please convert to PDF once
complete). *NOTE: you are not required to use this template. If you have a CV available in
another format, you may upload it instead.