WALTHAM™ Foundation

2019 Research Awards Application Form

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WALTHAM™ Foundation Research Award Application

1. Application Instructions

This application form must be submitted as a single PDF file, to include the ‘Application Details’, ‘Project Proposal’, ‘Ethics Certification’, ‘Timeline’, ‘Budget Breakdown’, ‘Involvement of human/animal participants’ and ‘Institutional acceptance of overheads funding/awards requirements sections described below. Text must be single spaced and Arial or Times New Roman (font size 11 minimum). Margin sizes must not be altered and page limits must be adhered to. If you reproduce the application form in your own word processing package, you must retain the same wording and layout used in this form.

The red italics text below has been added to assist in writing the application and should be removed from the form before its submission.

FAILURE TO ADHERE TO THESE INSTRUCTIONS WILL RESULT IN YOUR APPLICATION BEING REJECTED WITHOUT REVIEW.

Application submission:

Attach your single pdf application file to an email message with the subject header: “WALTHAM Foundation Research Award Application 2019”.

Send it to: waltham.foundation@waltham.com

Application Deadline 1 st May 2019

2. Application Details

Please complete the table below, removing all guide text in red italics once completed.

Title The project title should be as brief as possible and should not exceed two lines of legible text.

Title, first name, surname, job title and affiliation of principal applicant (must have Ph.D., Ed.D., or equivalent)

Fill in title, first name, surname (family name) and job title, in this order, of the person to whom all correspondence should be addressed (e.g., Dr. Anne Smith, Professor of Veterinary Medicine).

Title, first name, surname, job title and affiliation of all other applicants

Information should be given in the stated order.

Contact details for principal applicant Include the address (including country and postal/zip code), telephone

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(address, country, telephone, e-mail) number (including country code), and e-mail address of the principal

applicant.

Address(es) at which the project will be conducted if different from above

If the proposed project is field based, identify the field address.

If the project is likely to be conducted at more than one research centre, please identify each centre.

Summary of relevant experience of principal applicant (250 words maximum)

This should include key positions held and relevant research experience of the principal applicant.

Relevant references of principal applicant or research group (max 5 relevant references)

Include full details of each publication (maximum 5 publications).

Duration of project (up to a two years maximum)

Proposed top line duration of the projects in months/years up to a maximum of 2 years. A more detailed time line should be added to section 4 of this application form.

Total budget requested (in USD)

The total sum of funding requested in USD for the project, typical up to $25,000 (USD). A more detailed budget break down should be added in section 5 of this application form.

Project objectives (50 words maximum)

Project abstract (maximum 500 words)

Included a brief background, rationale, methodology and predicted outcomes

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3. Project proposal (maximum 5 pages)

The project proposal should be a self-contained description of the proposed work with relevant background, and should not depend on additional information. Applicants must not include URLs to web resources in order to extend their proposal.

The project proposal description should include the following sections:

Background:

• Introduce the topic of research and explain its academic and wider context.

• Demonstrate a knowledge and understanding of past and current work in the subject area both nationally and internationally.

Experimental Design/Methodology:

Please include the following subsections:

• Aims - Identify the overall aims of the project and the individual measurable objectives against which you would wish the outcome of the work to be assessed. This should refer to the objectives set out in this application form (see project objectives in section 2 above).

• Procedure - Detail the methodology to be used in pursuit of the research and justify these choices

• Participants – If applicable, specify the number, description and source of participants and include information on statistical powering to support the number of participants to be included if applicable.

• Data Analysis – Detail and justify the plan for data analysis and link this plan directly to the experimental design and procedure.

Impact:• Explain why the proposed project is of sufficient timeliness and novelty to warrant

consideration for funding.

• Specify the milestones that can be used to measure the progress of this project and explain how the project will be managed. You may wish to refer to your timeline in section 4.

• A summary of the key outcomes, possible applications, and benefit(s) of this project to companion animals.

References:

References should appear in a list at the end of the project proposal and be linked to relevant text by, for example, sequential numbering and superscript reference numbers embedded in the body of the document. Only one publication should be listed for each number.

Lists of references and illustrations should be included in the five page limit and should not be submitted as additional documents or as appendices.

Within the list of references, URL links to relevant publications are permissible.

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4. Timeline (maximum 1 page)

Please include a one page timeline clearly indicating the expected completion of major milestones for this project. (E.g., participant recruitment, data collection, data analysis, etc…)

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5. Budget breakdown (maximum 2 pages)

Provide a complete and detailed breakdown of the budget along with a brief justification of these expenses. The total should add up to the total budget requested in section 2 above. Please be as specific and accurate as possible, including:

– Animals, husbandry care, animal diets, and consumables, where applicable.

– Identify and give a breakdown of other sources of funding required to complete this project.

– Funding will not be provided for travel and accommodation unless it is for essential fieldwork. The grant will not support travel and subsistence or registration for scientific meetings, conferences, or workshops. Funding will not be provided for the purchase of equipment or computers.

– Combined overhead or university indirect costs must not exceed 10% of the total amount requested.

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6. Ethics Certification

I confirm that every effort will be made to ensure that the proposed research will not result in pain or suffering of participating animals and that no animals will be euthanized as a result of this project. I also confirm that Certification of Humans Subjects Board/Institutional Review Board and Institutional Animal Care and Use Committee/Animal Ethics Committee approval including the title of the project, name of the program director /principal investigator, date of approval, and appropriate signatures and a copy of the approved informed consent form (if applicable) must be received by the WALTHAM™ award administrator prior to transfer of funds to the grantee institution.

Signature of principal applicant:

Date:

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7. Involvement of human participants (maximum 2 pages)

Please include up to a maximum of two pages if applicable to describe your proposed project with regards to each of the following points:

• Human subjects involved (number and demographics)

• Method of recruitment and informed consent of any human subject

• Potential risks to subjects

• Protection against risk

• Potential benefits of the research to the subjects/importance of the knowledge to be gained

• Data security and safety monitoring

Funding will be subject to successful University/Institute ethics approval

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8. Involvement of animal participants (maximum 2 pages)

If animals or animal tissues are included in the project, please include up to two pages as necessary to describe your proposed project with regards to each of the following points:

The number and characteristics of animals involved in the project and how this number was derived (i.e., statistical validity). What alternatives to animals were considered and why did you not choose these? Describe how you will minimize the impact of your project on any animal involved.

Potential benefits of the research to the animals/importance of the knowledge to be gained along with any potential risk to the animals and protective steps proposed against these risks.

Source and ownership of animals (e.g., client-owned, a university resource, shelter animals). Where animals are client-owned, it should be made clear in the protocol that owners will be asked to give written consent for the participation of their pet in the project and that they are fully aware of all procedures their pet (or samples from the pet arising from clinical evaluation) will be undergoing.

Housing and husbandry conditions, including diet and supplements being fed.

The fate of the animals at the end of the project. The WALTHAM Foundation will not support any project that results in the harming of any animal.

For clinical studies, state how sufficient clinical cases will be obtained.

For projects involving animals/animal tissue as part go the project, funding will be subject to the WALTHAM™ Animal Welfare and Ethics Review Board, which will require an additional short approval process if this application is shortlisted.

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9. Statement of Institution acceptance and signature of the authorized institutional agenda and the Principle applicant.

9.1. Statement of Institutional acceptance of the award requirements, including institutional overheads limited to 10% of the total award value (maximum one page)

Signature of an authorized institutional agent (e.g., head of school, dean, provost, Head of sponsored programs, university finance officer, or equivalent):

Date:

Please include written institutional acceptance of the award requirements including acceptance that funding to cover institutional overheads is limited to 10% of the total award value, within the award limit, along with the signature of an authorized institutional agent.

9.2. Signature of Principal applicant:

Date:

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