test | Glaucoma Research Society of Canada

PART A: Funding Period 1 year

Required fields are marked with an *

Title of Research Proposal: *

Author’s Name: *

Amount of Funds Requested: *

New or renewed project? *

New Proposal: Please complete Parts B, D and E
Renewal of Current Project: Please complete Parts C, D and E

Note: Only two renewals of projects previously funded by the Glaucoma Research Society of Canada will be considered.

Please summarize the objective, hypothesis and plan of your research proposal

Part B.FOR NEW PROPOSALS

Please describe your FULL RESEARCH PROPOSAL (maximum 3 pages)

Budget Breakdown

PART C: FOR RENEWAL OF CURRENT PROJECT

Note: Only two renewals of projects previously funded by the Glaucoma Research Society of Canada will be considered.

Please summarize how GRSC’s 2017 grant helped your project progress (maximum 1 page)

Please describe in detail (maximum 2 pages) the research you want to continue to conduct

Budget Breakdown

PART D: CURRICULUM VITAE OF PRINCIPAL INVESTIGATOR AND CO-APPLICANTS

Please provide the following information for the principal investigator and co-applicants

Eligibility

a) Current University appointment:

Academic Research Program:

Masters
PHD Thesis

Name of supervising preceptor

Location

University
Academic Hospital

Post Doctoral Student Studies/Clinical Research Fellowships

Name of supervising Clinician Researcher in Canada

Required Documents

Degrees and diplomas

Including dates and confirming institutions (attach sheets as required)

Publications in peer reviewed journals

During the past 10 years (attach sheets as required)

Other grants

Include any overlapping grant submissions or parallel applications (attach abstracts)

PART E: APPLICANT(S) INFORMATION

Principle Investigator

Name and title *

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Phone

Fax

Date

University/Hospital Signing Authority