INTERNATIONAL MYELOMA FOUNDATION
2012 Brian D. Novis Research Award
Junior Grant Application
JUNIOR GRANT APPLICATION
INTERNATIONAL MYELOMA FOUNDATION
2012 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 $50,000. 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.
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International Myeloma Foundation
2012 Junior Research Award Application Instructions
QUALIFICATIONS
The qualifications for a candidate for the Brian D. Novis Research Award include the following:
Completed postdoctoral studies or clinical fellowships no later than August 1 of the application year.
Ability to devote a minimum of 50% of his or her time to the research project during the Award year.
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 Monday, August 1, 2011.
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 1, 2011.
2. Curriculum vitae, including bibliography.
3. One page abstract of the proposed research, along with a one page list of relevant literature citations.
4. Summary (not to exceed five pages, excluding references, figures and tables) of the research project,
outlining (in this order):
a. Specific aims
b. Methods, novelty and significance
c. Facilities available
d. Previous experience of the researcher and preliminary work accomplished, if applicable
5. Letters of support or commitment from collaborators needed to complete the proposed project (if
applicable).
6. Clear and explicit outline detailing the facilities to be used and exact space and equipment
requirements. Any institutional clearances required to conduct the research should be appended to
this section. (Institutional overhead must not exceed 10% of the grant award.)
7. Biohazards statement. An institutional statement and assurances regarding potential biohazards and
safeguards must be included.
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8. 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.
9. Publications. Three (3) 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.
10. Statement giving details of any additional 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.
11. Letter of recommendation:
a. Recommendation by a department head/mentor or senior advisor at your institution, critically
evaluating the merits of the proposed research and the candidate's qualification and ability to
conduct the research.
b. If nominee is not affiliated with the academic institution that will be the site of the proposed
research, a letter from a department chairperson or dean verifying the candidate's affiliation
with the institution and availability of additional resources for the research.
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.)
DEADLINE/SUBMISSION ADDRESS
Complete applications must be received in the IMF office by 5 p.m. on August 1, 2011.
Lisa Paik, IMF Vice President of Clinical Education & Research Programs
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 ($50,000) 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, 2012. The Award may be used
for laboratory supplies for the research proposed.
The first installment of the award (1/3 of $50,000) will be dispersed in January 2012. The recipient is
required to submit a six (6) month progress report ­ due June 15, 2012. 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, 2012.
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 2012 Junior 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 _____
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 _____
Budget Category
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 total award [i.e. $5,000])
To clarify: Direct costs may total $45,000 & Indirect Costs may total $5,000
8. TOTAL COSTS (6+7 must not exceed $50,000)
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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. Use continuation sheets as necessary.
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_____________________________________________
Applicant Name
Page ______ of _______
INTERNATIONAL MYELOMA FOUNDATION
2012 Brian D. Novis Research Award Junior Grant
Application Check List
Four complete copies (one original, three photocopies) of the application are required. Use the following
checklist to ensure all required materials are submitted and in the proper order.
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.
Five page summary (not to exceed five pages) outlining the research project.
5.
Letters of support or commitment from collaborators needed to complete the
proposed project, if applicable.
6.
Clear and explicit outline detailing the facilities to be used and exact space and
equipment requirements. Any institutional clearances required to conduct the
research should be appended to this section. Institutional overhead must not
exceed 10% of the grant award. (Do not exceed $5,000 with your institutional overhead)
7.
Biohazards statement.
8.
Laboratory Animals statement, if applicable.
9.
Publications. Three (3) 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.
10.
Statement giving details on any other funding for the research.
11.
Letter of recommendation.
12.
Application Check List.
Send the original (PDF or hardcopy [lpaik@myeloma.org]) + three (additional copies) to the
International Myeloma Foundation:
Lisa Paik, Vice President, Clinical Research and Research Initiatives
12650 Riverside Drive, Suite 206
North Hollywood, CA 91607 USA
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