BUILD EXITO Early Career Investigator Award Application Application From: Principal Investigator Name Amount Requested: From Through Date Brief descriptive title of project: Date Career Development Award opportunity of interest for future application (please provide name of sponsor, title of award, and link to guidelines): Sponsor Name: Award Title: Link to Award Guidelines: In 250 words or less, summarize the proposed work in space below using lay language:
ECI Grant Application I. Name and Title of Principal Investigator: II. Name(s) and Title(s) of associated personnel (Do not list anyone included in the personnel category of the budget): Did you submit a proposal to BUILD EXITO Pilot Project RFA 1 (funded in 2016)? Yes No Did you submit a proposal to BUILD EXITO Pilot Project RFA 2 (will be funded in Aug 2017)? Yes No III. Proposed budget for 12 months or less. Please provide justification of all major items in the budget (Append as necessary). Personnel (include fringe benefit as a separate amount): Personnel $ Fringe Benefit $
Permanent Equipment: $ Expendable Supplies and Services (itemize and justify) $ Direct Costs (cannot exceed $25,000) $ Indirect Costs (48.5% of MTDC) $ Total Budget $
IV. Other Support (Append as necessary) a. List sources of current research support you receive for all research projects. Include project titles, amount of annual budget, number of years, dates, and role on the project. b. List sources of pending funding for all research projects. Include project titles, amount of annual budget, number of years, dates, and role on the project. c. Append budget pages and abstracts for all current and pending support for research projects for which you are the Principal Investigator or Co-Investigator. V. Research Plan and Other Supporting Information Using no more than six (6) single-spaced additional pages, in a font no smaller than 12 point and side margins of at least one inch, please give your research plan in detail sufficient to permit determination of merit. This six-page limit includes graphics and other illustrations. It does not include literature cited in the final research plan or questionnaires. Recognize that many of the reviewers are not experts in your field. The plan should include background, preliminary studies if applicable, methods, feasibility and timeline, and discussion as to how data will be interpreted. Include a brief discussion outlining the PI s career development plans in research. How will the proposed project advance your plans? What skills do you feel you most need to develop to advance your plans (e.g., new methods, specialized equipment training). Address the PI s intentions to pursue Career Development funding through NIH or another agency. Describe the plan to use the data collected under this award to apply for future career development awards. VI. Other Information and Attachments You must include the following items with your application and proposal: Principal Investigator s biographical sketch confirming to the current NIH format. Chair and Mentor documents are to be submitted separately: Letters from your Department Chair and Mentor see Section III of Application Guidelines. Mentor s biosketch
Please refer to Section II.D. of Application Guidelines for the order in which these items should be attached. VII. Will human subjects be involved in this project? Yes No If Yes, does this application include IRB approval? Yes No Pending VIII. Will vertebrate animals be involved? Yes No If Yes, does this application include approval by your Institution s Animal Care and Use Committee? Yes No Pending IX. Will recombinant DNA/infectious agents or biologically-derived toxins be involved? Yes No If Yes, does this application include approval by your institution s Biosafety Committee? Yes No Pending Funds will not be made available until IRB/IACUC/IBC approval has been provided to Sponsored Projects Administration.