Collaborative Research and Innovation Fund

Fields denoted by an asterisk (*) are required.

1. Application Details
Title of Project:
Research projects must be developed jointly by two co-PIs, one of whom must be a Basic Scientist primarily appointed in PaLM and the other a Clinical Scientist (PhD) or Clinical Academic (MD or equivalent) at LHSC.
Applicant 1: Applicant 1: First Last
Applicant 1 Email:
Applicant 2: Applicant 2: First Last
Applicant 2 Email:
Co-Investigators:
To which theme(s) of research does the project align (check all that apply):

To which theme(s) of research does the project align (check all that apply): Bioinformatics and Data Science Cancer Biology Cardiovascular, Respiratory Health and Metabolic Diseases Computational Pathology (Epi)genetics Infection, Immunity and Inflammation Interdisciplinary Research in Health and Education One Health Oral Biology and Medicine Pathobiology of Neurologic Disorders Regenerative and Transplantation Medicine Test Utilization, Optimization and Quality Assurance
Location of Research Study:
Period of Support (up to 2 years):
Total Budget Requested:
Has this project been submitted for review by an appropriate Western University Research Ethics Board?

Has this project been submitted for review by an appropriate Western University Research Ethics Board? No, not applicable (No human subjects) Yes, approved (copy of approval notice attached) Yes, approval pending Not yet submitted
Please attach a copy of approval notice

Attach Files
Has this team worked together previously on a research project/collaboration?

Has this team worked together previously on a research project/collaboration? No Yes
If yes, please describe the nature and outcomes of previous collaborations between the two applicants:
If yes, please provide detail on how the new research collaboration is different from previous work:
Has this project, in part or full, been submitted for funding from other internal or external sources?

Has this project, in part or full, been submitted for funding from other internal or external sources? No Yes
If yes, please provide details on the pending application(s), including the sources of funding, anticipated time of award notification, and potential budgetary overlap with CRIF application.
2. Research Proposal:
2.1 Background and purpose of the project:
2.2 Research methodology:
2.3 Expected results:
2.4 Role of Applicant 1 on this project:
2.5 Role of Applicant 2 on this project:
2.6 Other personnel involved in the project:
2.7 Explain plans for subsequent competitive submissions to research sponsors external to the Department:
2.8 Please attach any additional information related to the research proposal:

Attachments are limited to a total of 5 pages and may include items such as brief CVs of applicants (student CVs may be included in the Budget section below), references, tables/figures, and other items relevant to the project.

Attach Files
3. Budget and Budget Justification:
3.1 Itemized Budget:

If any of these categories do not apply, please type N/A.
Undergraduate student salary support (include 4% vacation pay, 14% benefits):
Graduate student support:
Consumables/Supplies:
Publication costs:
Other costs:
TOTAL:
3.2 Budget Justification:

The budget justification is a categorical description of the proposed costs of the project and should address each of major cost categories.

Undergraduate student(s): should not include salary for students in the 4th year of the Bachelor of Medical Science (BMSc) Honours Specialization Programs, Scholars Elective program conducting research as part of their program, and Work-study program. For undergraduate students to be hired (e.g. as research assistants), provide a breakdown of the effort on this project, and the hourly rate (including 4% vacation pay, 14% benefits).

Graduate student(s): please attach curriculum vitae and the academic record of the student and/or proof of acceptance in the Department of Pathology and Laboratory Medicine Research-based graduate programs.

Consumables/Supplies: whether proposing supplies as a single category or using broad subcategories, describe the supplies/materials that make up the costs proposed.

Publication costs: provide details on anticipated number of publications and target journals.

Other costs: describe costs not covered in the other major categories.
3.3 Please attach any additional budget information:

Attachments may include student’s CV, student’s academic record and proof of acceptance, research quotes and other budget-related items.

Attach Files

Collaborative Research and Innovation Fund

Collaborative Research and Innovation Fund

1. Application Details

2. Research Proposal:

3. Budget and Budget Justification:

3.1 Itemized Budget: