EmailThis field is for validation purposes and should be left unchanged.APPLICANT FORM Research Grants - Leukaemia, lymphoma or blood related diseases ELIGIBILITY: The scheme is open to researchers in all faculties and institutes of the University of Tasmania; departments within Tasmanian hospitals; and the Department of Health and Human Services. The research must focus on leukaemia, lymphoma or blood related diseases. It includes population health strategies, medical research, clinical and psychosocial care An individual can only be listed on one grant as a lead chief investigator (CI) at any one time. Achievement of deliverables on previous DCLFtas grants will be considered when assessing requests. Closing date and time of the scheme, formatting length and supporting documentation requirements must be strictly adhered to. Applicants not meeting these requirements will not be eligible for funding. ASSESSMENT CRITERIA: Quality of the research proposal, including feasibility and budget (50%) Research capacity, including track record and research team (25%) Applications with an early career researcher as the lead investigator will receive additional 20% weighting in this category. Please indicate on the form if you are an early career researcher. This includes those who obtained their PhD or highest degree ≤ 5 FTE years ago or who have had no grants as a lead investigator (>$10,000). If you are unsure whether you meet this criterion, please contact DCLFtas. Research significance and innovation, including alignment with the strategic direction of DCLFtas and broader contribution to the field of research (25%). ASSESSMENT PROCESS: Full electronic applications must be submitted to enquiries@DCLFtas.org.au Applications will be distributed to the relevant review panel. Members of the panel will individually assess, score and rank applications. Ranked applications will then be discussed at a DCLFtas meeting to consolidate a score and ranking. The committee of DCLFtas will then make a funding recommendation. Applicants will be informed of their outcome. CONDITIONS OF GRANT The term of each funding round will be 12 months. Research funding must be spent, as outlined in the application, by the project close date. Unspent funds will be reclaimed. A Final Report must be submitted. No part of the funding is to be used for external conference attendance. If a sole CI leaves their current employment, then the grant must be relinquished. Funding cannot be used for salaries, or to fund a Research Higher Degree candidate’s stipend or fees. Funding is subject to investigators obtaining relevant ethics committee approvals. SEND COMPLETED FORM TO: researchgrants@DCLFtas.org.auCHIEF INVESTIGATOR DETAILSLead CI Name:(Required) First Last CI Highest Qualification(Required)CI Early Career Researcher(Required)CI School/Institute(Required)CI Phone(Required)CI Email(Required) INVESTIGATOR DETAILSInvestigator #1 Name:(Required) First Last I #1 Highest Qualification(Required)I #1 School/Institute(Required)I #1 Phone(Required)I #1 Email(Required) I #1 Early Career Researcher(Required)Investigator #2 Name: First Last I #2 Highest QualificationI #2 School/InstituteI #2 PhoneI #2 Email I #2 Early Career ResearcherREVIEWER DETAILSReviewer #1 Name:(Required) First Last R #1 Highest Qualification(Required)R #1 School/Institute(Required)R #1 Phone(Required)R #1 Email(Required) Reviewer #2 Name:(Required) First Last R #2 Highest Qualification(Required)R #2 School/Institute(Required)R #2 Phone(Required)R #2 Email(Required) PROJECT DETAILSRESEARCH PROPOSAL (50%) - Max 3 pages Include: Project Title; aims and hypotheses; research plan, including background and methods; timeline, including likely outputs within a 24 month period; and budget. RESEARCH SIGNIFICANCE AND INNOVATION (25%) - Max 1 page How does your project align with the current strategic direction of DCLFtas? How is your project significant and/or innovative in relation to the broader field of research? RESEARCH CAPACITY (25%) - Max 3 Pages A list of publications and grants (include title of project, investigators, funding body, total amount, years funded) within the last 6 years (including the first 6 months of this current year). A track record statement for the CI’s team Description of key research outputs including most significant publications and those that demonstrate collaboration between team members Contribution to discipline or area, which includes, but is not limited to, invitations to speak at meetings, conferences or contributions to development of policy or clinical guidelines Other research-related achievements. These could include influence on policy or practice or community engagement Note: These categories align with those requested for project grants by the NMRC Research capacity is assessed for the last 6 years, including the first 6 months of the current year. Career interruptions can be detailed in a separate attachment. ATTACHMENTS List of publications and grants in the previous 6 years Track record statement(s) Career disruptions AUTHORISATIONLead CI Signature:Your NameYour NameYour NameYour NameHead of School or Department Signature:Your NameYour NameYour NameYour NameCI Signed Date Head Signed Date By signing below, you confirm that this application will achieve the proposed outputs and that the grant can be accommodated in the School/Faculty/Institute. If the lead CI is the Head of School then the Dean of the Faculty must authorise this form. FACULTY ASSESSMENT (Office use only)Proposal (50%)Capacity (25%)Significance (25%)OverallSCORING 7 = outstanding by international standards 6 = excellent 5 = very good 4 = good 3 = marginal 2 = unsatisfactory 1 = poor These align with the NHMRC project grant category descriptors. For significance, for a project to score a 6 or 7 it must clearly align with the DCLFtas strategic direction. Comments