INTERNATIONAL MYELOMA FOUNDATION
2011 Brian D. Novis Research Award
Senior Grant Application
SENIOR GRANT APPLICATION
INTERNATIONAL MYELOMA FOUNDATION
2011 BRIAN D. NOVIS RESEARCH AWARD
Provided by donations from private individuals
The International Myeloma Foundation funds several research grants including the Brian D. Novis Research
Award. These grants are provided through donations from private individuals, and are presented annually by
the International Myeloma Foundation. These awards go to doctors/researchers doing work in the field of
multiple myeloma. This year's awards will be in the amount of $80,000. The Brian D. Novis Award honors
the IMF's founder Brian Novis, who died of multiple myeloma in July of 1992. The International Myeloma
Foundation is a non-profit organization whose mission is to improve the quality of life for myeloma patients
while working toward prevention and a cure.
International Myeloma Foundation
2011 Senior Research Award Application Instructions
QUALIFICATIONS
These awards are targeted to established investigators with a track record in myeloma or related research, and are
designed for projects which represent a different focus, direction or area of research from those in which they are
currently funded. In most cases, these awards will be for pilot projects to obtain sufficient funding for larger
applications from NIH or similar larger funding agencies.
The qualifications for a candidate for the Brian D. Novis Senior Research Award include the following:
· Ability to provide a completed application with evidence of a meritorious research project.
· Must complete and return application package to the IMF no later than Tuesday August 31, 2010.
APPLICATION
A complete application should be submitted to the IMF directly by the candidate and must include the
following:
1. Original application along with three (3) copies.
Ideally we welcome a completed application saved as a PDF file and sent electronically by email to
Lpaik@myeloma.org in addition to 3 hard copies mailed to the address provided on or before
August 31, 2010.
2. Curriculum vitae, including bibliography.
3. One page abstract of the proposed research, along with a one page list of relevant literature citations.
4. Project description (not to exceed ten pages, excluding references, figures and tables) of the research
project. The project description should be presented in the following sequence:
a. Specific aims (approximately 0.5 page).
b. Scientific background and clinical significance of proposed work (approximately 1.5 pages).
c. Previous work/preliminary data (approximately 1.0 page).
d. Methods (approximately 2.0 pages).
e. Plans for clinical application of the data (approximately 0.5 page). Clinical research
protocols, if part of the application, should be submitted as Appendix material to this section.
Include IRB approval date (if protocol has been approved) and IRB Compliance number.
f.
Briefly state how your project will lead to sufficient preliminary data to support a major grant
application.
g. How does this work relate to current work in the field, as well as to work previously
performed by the applicant
5. Letters of support or commitment from collaborators needed to complete the proposed project (if
applicable).
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6. A clear and explicit outline detailing the facility to be used and the exact space and equipment
requirements.
7. Any institutional clearances required in conducting the research, list briefly -- Institutional Overhead
must not exceed $8,000 (10% of the total award amount).
8. Biohazards Statement. An institutional statement and assurances regarding potential biohazards and
safeguards must be included.
9. Laboratory Animals Statement, if applicable. For projects that involve laboratory animals, the
Institutional Animal Care and Use Committee (IACUC) Approval Date and Animal Welfare
Assurance number must be given.
10. Publications. Four (4) sets of the applicant's publications that are relevant to the proposed project
should be included. Attach one set to the original application and one set to each of the first three (3)
copies of the application.
11. Statement giving details on any other funding for this research. The IMF reserves the right to decline
or revoke funding if simultaneous funding has been awarded from another source. At the time of
submission, applicants must disclose whether this project has also been submitted to other institutions
for funding.
12. Completed Application Check List (included in this document) for each of the three (3) application
copies.
FORMAT
Application materials must be submitted in the order listed in the Application section. Pages should be
numbered and submitted in page order, beginning with Page 1 of the Application Form. Applications must
be printed or typed on one side only of each page. Page lengths are based on standard one-inch margins,
single-spaced, with a type size no smaller than 10 points in a standard font. No unsolicited documentation or
additional letters of recommendation will be considered. Any proposals arranged to comply with other
funding entities' guidelines must be redone to meet the specification outlined herein.
DELIVERY GUIDELINES
Applications may be delivered to the IMF by U.S. mail, express delivery, or courier. No part of the application may
be submitted by facsimile transmission (FAX). To ensure delivery, candidates may wish to send applications via a
method that requires signature (i.e. Federal Express or registered mail, return receipt requested.)
Ideally, we would most welcome a completed application, saved as a PDF file and emailed to
lpaik@myeloma.org.
DEADLINE/SUBMISSION ADDRESS
Complete applications must be received in the IMF office by 5 p.m. on August 31, 2010.
Lisa Paik, Vice President of Clinical Education & Research Initiatives
12650 Riverside Drive
Suite 206
North Hollywood, CA 91607 USA 1 (818) 487-7455
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CONFIRMATION
You will receive a confirmation email from the IMF upon receipt of your application.
SELECTION
The selection of the recipient will be made by an Award Committee of the Scientific Advisory Board of the
IMF, consisting of experts in the field of multiple myeloma. Candidates are strictly prohibited from
contacting members of the Award Committee about the status of their application; any violation of the
regulation will lead to the automatic disqualification of the application.
Selection and Considerations
The Award Committee will consider most favorably those proposals that provide evidence of an
applicant's research initiative and creativity. The Committee will also weigh the previous
accomplishments of the applicant, the probability of meaningful results from the proposed research, and
the likely contribution of the research to the advancement of our knowledge of myeloma etiology,
diagnosis, treatment, or prevention.
Selection Notification
All candidates will receive notification from the IMF office of the final selection of a recipient by the
IMF via email or mail.
AWARD CONDITIONS AND REPORTING
The monetary Award is provided to the recipient's sponsoring institution for the direct support of the
recipient's work during the Award year, which will begin on January 1, 2010. The Award may be used for
laboratory supplies for the research proposed.
The first installment of the award (1/3 of $80,000) will be dispersed in January 2011. The recipient is
required to submit a six (6) month progress report ­ due June 15, 2011. The second installment of the award
will be dispersed after the progress report has been received and reviewed by the Chairman of the IMF
Scientific Advisory Board. The third, and final installment, will be dispersed before November 1, 2011.
Send your six-month progress report to:
Dr. Robert Kyle
Mayo Clinic
200 First Street, SW
Stabile 628
Rochester, MN 55905
Kyle.Robert@mayo.edu
At the conclusion of the award year, the recipient is required to submit a brief written summary of the
research conducted, as well as, a detailed account of the use of Award funds. The IMF should be
acknowledged in support of the research funded.
The recipient will be encouraged to submit the results of the research for presentation at a major scientific
meeting and/or submit a manuscript for publication in a major scientific journal as soon as meaningful
results are obtained. If the opportunity allows recipients will be invited to participate in IMF sponsored
scientific patient and other seminars/meetings.
If the recipient receives a commitment for financial support for the proposed project from more than one
funding entity, the applicant must inform the IMF immediately concerning any potential conflict and in
no instance can accept funding from more than one entity for the same project.
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____________________________________________
Applicant Name
Page _____ of _____
International Myeloma Foundation
2011 Senior Research Award Application Form
1. Project Title:________________________________________________________________________
2. Applicant:____________________________________ Degrees:_____________________________
Institution:_______________________________________________________________________
Department:______________________________________________________________________
Address:_________________________________________________________________________
City:_____________________________________________________________________________
State: ________________________________________Zip:________________________________
Country:_________________________________________________________________________
Fax:_______________________________E-Mail:________________________________________
3. Total Amount Requested: Year 1:__________________________
4. We, the undersigned, have reviewed this application for a International Myeloma Foundation
Award and are familiar with the policies, terms, and conditions of the IMF concerning this
research support and do hereby accept the obligation to comply with all such policies, terms and
conditions.
Please type the following:
_______________________________________________________________________________________
5. Applicant
Signature
Date
_______________________________________________________________________________________
6. Individual Authorized to
Signature
Date
Sign for Institution
_______________________________________________________________________________________
7. Fiscal Officer
Signature
Date
8. Address of Fiscal Officer:
_________________________________________________________
_________________________________________________________
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____________________________________________
Applicant Name
Page ____ of _____
CERTIFICATION
I certify that, to the best of my knowledge, all of the information contained in this application form is true
and the research as proposed to be conducted by the applicant would comply with all of the standards of the
sponsoring institution.
APPLICANT_______________________________________________________________________
Signature
Date
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____________________________________________
Applicant Name
Page ____ of _____
Abstract-Scientific: Briefly describe your proposed project in 100 words or less using technical language.
Abstract-Lay: Briefly describe your proposed project in 100 words or less using non-technical language.
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___________________________________________
Applicant Name
Page ____ of _____
Biographical Sketch: Please provide the biographical sketches of all key personnel in NIH format. Do not
exceed four pages per biographical sketch.
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___________________________________________
Applicant Name
Page ____ of _____
BUDGET
Budget Category
1. PERSONNEL:
NAME
ROLE
% EFFORT
TOTAL PERSONNEL:
2. SUPPLIES: (Itemize by Category)
TOTAL SUPPLIES:
3. EQUIPMENT: (Itemize)
TOTAL EQUIPMENT:
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__________________________________________
Applicant Name
Page ____ of _____
4. OTHER EXPENSES: (Itemize by Category)
TOTAL OTHER EXPENSES:
5. TRAVEL
6. TOTAL DIRECT COSTS (1+2+3+4+5)
7. INDIRECT COSTS (Maximum: 10% of the total award [i.e. $8000].
To clarify: Direct Costs may total $72,000 & Indirect Costs may total $8,000
8. TOTAL COSTS (6+7)
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__________________ ___________________________
Applicant Name
Page ______ of _______
Budget Justification:
Please provide a justification for each item in budget. Use continuation sheets as needed.
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Applicant Name_________________________
Page ______ of _______
Other Research Support:
List all active and pending research support for applicant and for all key personnel named in the application.
Include all support available for the proposed work during the project period. For each item, please give the
source of support, identifying number, project title, name of principal investigator/program director, annual
direct costs, and total period of support.
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_____________________________________________
Applicant Name
Page ______ of _______
INTERNATIONAL MYELOMA FOUNDATION
2011 Brian D. Novis Research Award Senior Grant
Application Check List
Four complete copies (one original, three photocopies) of the application are required.
COMPLETED
ITEM
/ INCLUDED
1.
Application provided by the IMF.
2.
Curriculum vitae including bibliography.
3.
One page abstract of the proposed research along with a one page list of relevant
literature citations.
4.
Ten (10) page summary (not to exceed ten pages) outlining the research.
5.
Letters of support or commitment from collaborators needed to complete the proposed
project (if applicable).
6.
A clear and explicit outline detailing the facility to be used and exact space and
equipment requirements.
7.
Any institutional clearances required in conducting the research. (Institutional overhead
must not exceed 10% of the grant award. Do not exceed $8,000)
8.
Biohazards statement.
9.
Laboratory Animals statement (if applicable).
10.
Publications. Four (4) sets of the applicant's publications that are relevant to the
proposed project should be included. Attach one set to the original application and one
set to each of the first three (3) copies of the application.
11.
Statement giving details on any other funding for the research.
12.
Clearly and explicitly outline the details of the facility to be used, exact space and
equipment requirements and if necessary provide letters of support or commitment from
collaborators needed to complete the proposed project.
13.
Application Check List.
Send the original (PDF or hardcopy [lpaik@myeloma.org]) + three (additional copies) to the
International Myeloma Foundation:
Lisa Paik, IMF Vice President of Clinical Research and Research Initiatives
12650 Riverside Drive, Suite 206
North Hollywood, CA 91607 USA
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