2016 Strategic Research Grant
Letter of Intent (LOI) Application Form
A complete submission includes: 2016 CANet SRG LOI Application Form
2016 CANet SRG LOI Contact Information Sheet
Common CV (Draft) of the Scientific Program Lead
Common CV (Draft) of the Project Nominated Principle Investigator
Submission Guidelines:
Complete applications must be submitted by email on or before
4:00 pm EST on Thursday, November 26, 2015.
Send applications to:
research@canet-nce.ca (Size restriction: 10Mb)
Questions related to this program can be directed to:
bpickard@canet-nce.ca or koneil@canet-nce.ca
** DO NOT CHANGE THIS FORM’S FILE FORMAT **
CONTENTS
PROGRAM DESCRIPTION ............................................................................................. 1
Program Characteristics ........................................................................................... 3
Relevance of the Program to CANet’s Strategic Research Plan ....................................... 2
Program Classification .............................................................................................. 2
PROJECT DESCRIPTION .............................................................................................. 5
Project Classification ................................................................................................ 7
PROJECT BUDGET ...................................................................................................... 8
Leveraging Guidelines .............................................................................................. 8
Project Budget Estimations ....................................................................................... 8
PROGRAM DESCRIPTION
Program Title
Provide a title that clearly describes the focus of the proposed research program
Page 1
[INSERT PROGRAM TITLE]
Program Scientific Lead
Name
Job title
Department
Faculty
Institution
Program Overall Aim (Max. 100 words)
Describe the problem/issue that the Program is intending to solve and state the overall aim of the
Program.
Relevance of the Program to CANet’s Strategic Research Plan
Relevance of the Program to CANet Strategic Research Plan: (Max. 100 words)
Describe how the Program is relevant to CANet’s Strategic Research Plan
Program Classification
Check all that apply:
CANet Research Foci
☐ Sudden Cardiac Death
☐ Atrial Fibrillation
☐ Syncope
Program Background (Max. 250 words)
Summarize the background of the Program including each of the following:
 a rationale for the Program and why it needs to be done now (What is the unmet need? Why is it
interesting? Who is interested in it? How do the knowledge users and/or partners view it?)
 the current standard of care and relevant state-of-the-art technologies
 results of preliminary studies, systemic literature reviews/knowledge syntheses
 any enabling or unique opportunistic factors that will support successful completion of the Program
Page 2
[INSERT PROGRAM TITLE]
Program Impacts (Max. 100 words)
Describe all potential impact(s) resulting from the Program (consider individual, health system, corporate
and societal perspectives)
Program Objectives (Max. 150 words)
Describe the specific objectives of the Program and how they will contribute toward CANet’s clinical,
training, and/or knowledge translation & commercialization goals.
Program – List all Projects within the Program (Max. 100 words)
Chronologically order each Project within the Program and provide:
 a descriptive title of each project
 type and aim of each project
NOTE: the first project in this list is the focus of the Project portion of this application
Timeline, Milestones and Deliverables (Max. 100 words)
Describe the overall timeline of the program and the approximate timelines of each project. Summarize
the milestones and deliverables of the program and each project. Applicants may wish to include a Gantt
chart to add clarity to the timeline. (Add more lines as needed)
Start/End
Description of
Proj #
Deliverable
date
activity/milestone
Program Characteristics
For each of the sections below, describe how your Program contains each of the following
characteristics. Please include a description of the roles partners will play in the Program.
Multidisciplinary (Max. 100 words)
Describe how your Program will involve researchers from different research disciplines as well as
knowledge users from different sectors.
Page 3
[INSERT PROGRAM TITLE]
Multicentre (Max. 100 words)
Describe which research centres will be involved in the Program as well as what role they will play.
Multi-sectoral (Max. 100 words)
Describe the various sectors (academic, clinical, industry, government, not-for-profit, public, etc.) that
will be involved in the Program as well as the role each representative will play.
Industry Partners (Max. 100 words)
List the industry (for-profit biotechnology or pharmaceutical) partners involved in the Program and
describe what role they will play.
Other Partners (Max. 100 words)
List other partners (government, professional, charity, etc.) involved in the Program and describe what
role they will play.
Knowledge and Technology, Exchange and Exploitation Plan (Max. 150 words)
See the Program Guide for details regarding this section.
Patient Engagement Plan (Max. 150 words)
Describe how patients will be meaningfully engaged in the Program and their integration (as members of
the research team) into the development of the program’s strategy, design and execution of Projects.
Describe the strengths of the Patient Engagement Plan and any needs that can be addressed to make it
successful.
Page 4
[INSERT PROGRAM TITLE]
PROJECT DESCRIPTION
Project Title
Project Nominated Principal Investigator (NPI)
Name
Job/Position title
Department
Faculty
Institution
Project Co-participants
List the names of the co-participants in the Project and indicate their role such as Principal Investigators,
co-Investigators, Collaborators, Research Staff and Partners (including patients and knowledge user
representatives from industry, government, not-for-profit/charities and the general public)
1.
2. (Add or remove as needed)
Project Overall Aim (Max. 100 words)
Describe the problem/issue that the Project is intending to solve and state the overall aim of the Project.
Project Background (Max. 150 words)
Summarize the background for the Project including each of the following:
 a rationale for the Project and why it needs to be done now (Why is it interesting? Who is interested
in it? How do the knowledge users' partners view it? What potential benefit does it bring to the
knowledge users?
 the results of preliminary studies, systemic literature reviews/knowledge syntheses
 any enabling factors that will support successful completion of the project
Project Hypothesis and Research Question(s) (Max. 100 words)
State the hypothesis and/or research question(s) to be addressed in the research Project. Describe the
problem or knowledge gap that the study will address for the knowledge user.
Page 5
[INSERT PROGRAM TITLE]
Project Objectives (Max. 150 words)
Summarize the objectives of the Project
Project Methods (Max. 400 words)
Provide a description of the methods to be employed in the proposed Project. Consider the feasibility
and any relevant contingencies.
Project Characteristics (multidisciplinary, multi-sectoral, partners, etc.) (Max. 100 words)
Indicate important characteristics of the Project and describe how they are integrated with the program.
Describe how industry and other partners are involved in the project.
Project Timeline, Milestones and Deliverables (Max. 100 words)
Describe the overall timeline of the Project and the approximate timelines of any phases/stages in the
Project (if applicable). Summarize the milestones and deliverables of each project phase. Applicants may
wish to include a Gantt chart to add clarity to the timeline
Proj Phase/Stage Start/end date Description of activity/milestone
Deliverable
Project Patient Engagement Plan (Max. 150 words)
Describe the various elements of the Patient Engagement Plan. Describe the strengths of the plan and
any needs that can be addressed to make it successful.
Project Highly Qualified Personnel Development Plan (Max. 100 words)
Describe the various elements and benefits of the HQP Development Plan as they relate to the Project.
Outline the novel elements of plan as compared with existing activities in the community.
Page 6
[INSERT PROGRAM TITLE]
Describe the Intended Outcomes and Impacts of the Proposed Project (Max. 150 words)
Describe the intended outputs and impacts of the Project if it were successfully funded in its entirety.
Project Classification
Check all that apply:
CANet Theme
Relevant Tri-Agency
☐
1. Technological innovations
☐ CIHR
☐
2. Safe, effective, cost effective
solutions
3. Empowering patients and
caregivers, implementing solutions
☐
CANet Research Foci
☐ Sudden Cardiac Death
☐ Atrial Fibrillation
☐ Syncope
CIHR Pillars
☐ 1. Basic
☐ 2. Clinical
☐ 3. Health Services ☐ 4. Social
☐ NSERC
☐ SSHRC
UK CRC Health Research Classification System
(HRCS)
Consult: http://www.hrcsonline.net/rac
Page 7
[INSERT PROGRAM TITLE]
PROJECT BUDGET
Leveraging Guidelines
Duration
(yrs.)
CANet Funds
Requested
(per year)
Financial
leverage
requirement
2
< $49,999
0.0%
2
$50,000 - $99,999
50%
2
$100,000 - $149,999
100%
3
$150,000 - $249,999
200%
3
$250,000 or more
300%
Example of annual Partner contribution requirement
(minimum 1/3rd cash)
A $49,000 per year grant would require no partner
contribution
A $50,000 per year grant would require an annual partner
contribution of $25,000 of which at least $8,334 (1/3rd)
must be cash
A $120,000 per year grant would require an annual partner
contribution of $120,000 of which at least $40,000 (1/3rd)
must be cash
A $125,000 per year grant would require an annual partner
contribution of $250,000 of which at least $83,333 (1/3rd)
must be cash
A $250,000 per year grant would require an annual partner
contribution of $750,000 of which at least $250,000 (1/3rd)
must be cash
Project Budget Estimations
Estimated CANet Amount
Request
Estimated Partner Contributions
Year 1
Year 2
Year 3
TOTAL
Page 8
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