LCRF 2016 Grant Program General Information Application Instructions: Please complete the form below to submit your grant application. For full details of the application requirements and grant terms, please see the Funding Opportunities page on the LCRF website. The deadline for submissions is July 1, 11:59pm US Eastern time. Project Name* Provide a project name using the format "2016-Last name". The project name will be used to track your application within our grants management system. Scientific Title* Character Limit: 250 Career Level* Please indicate the principal investigator's career level. Choices Student/Fellow/Trainee: Graduate students, postdoctoral or clinical fellows Young Investigator: Less than 4 years since faculty appointment Mid-career Investigator: 4-10 years since faculty appointment Experienced Investigator: More than 10 years since faculty appointment Extension* Is this an application for an extension of a previously funded project? Choices Yes No Prior Year Progress Update (if applicable) If this is an application for an extension, please include an update describing the progress made during the current / prior award period. File Size Limit: 5 MB Printed On: 13 April 2016 LCRF 2016 Grant Program 1
Program Director / Advisor Please use the fields below to provide the contact information of your Program Director / Advisor, if applicable. First Name Last Name Salutation (e.g. Mr., Ms., Dr.) Title Character Limit: 250 Telephone Email Administrative Grant Coordinator Please use the fields below to provide contact information of your Administrative Grant Coordinator or other contact person to whom administrative issues regarding the grant can be addressed. Note: if your institution requires that approval from the Grant Coordinator be obtained prior to submitting a grant application, this step must be completed prior to applying for an LCRF grant. LCRF assumes that applicants have obtained all necessary approvals prior to submitting their application. First Name* Character Limit: 30 Printed On: 13 April 2016 LCRF 2016 Grant Program 2
Last Name* Character Limit: 30 Salutation* (e.g. Mr., Ms., Dr.) Character Limit: 10 Title Character Limit: 50 Address 1* Address 2 City* State / Region* Character Limit: 20 Zip / Postal Code* Character Limit: 10 Country* Character Limit: 20 Telephone* Character Limit: 20 Email* Character Limit: 50 Proposal Proposal Summary* Use the space below to briefly state the proposal. Project Narrative* Please fully describe your project. Use the upload function below to upload the project narrative in PDF format with the naming convention "Last name-narrative.pdf". Printed On: 13 April 2016 LCRF 2016 Grant Program 3
Note that while there is no restriction on the specific format of the document, the project narrative should not exceed ten pages in length. Additionally, ten pages is a length limit - not a guideline. If you are able to describe your project in less space, you are strongly encouraged to do so. File Size Limit: 5 MB Deliverables Please describe any deliverables expected to be generated as a result of the proposed work (if applicable). Character Limit: 3000 Success Factors* Please use the space below to indicate what constitutes success of your project and what you will do to measure this. Alignment with LCRF's Mission* Briefly describe how the goals of the proposed project are consistent with the mission of the. Project Timeline* Provide the proposed project start date and anticipated dates of significant endpoints and / or milestones. Please upload the timeline in PDF format with the naming convention "Last name-timeline.pdf". File Size Limit: 1 MB Future Plans* Briefly describe any plans for the proposed project at the conclusion of the funding period (e.g. expecting to apply for further funding from sources such as organizations X, Y, and Z). Project Budget* Using the budget template below, please provide a detailed breakdown of key items for which funds are requested. Please closely review any budget restrictions listed under the Grant Terms on LCRF's Funding Opportunities page. Printed On: 13 April 2016 LCRF 2016 Grant Program 4
Budget template: https://www.lungcancerresearchfoundation.org/assets/uploads/default/lcrf- Budget-Template.xlsx Please save the file in PDF format and upload with the naming convention Last name- Budget.pdf. File Size Limit: 1 MB Additional Funding List any additional funding available for this project (if applicable). Include the source and amount of funding, and state whether this grant will be matched by any other funding source. Character Limit: 2000 Letter(s) of Support* Include at least one letter of support. The letter should be from the applicant s Program Director or Advisor and must include statements affirming the following: The applicant will be on academic staff during the grant period There is adequate space and equipment to accomplish the stated project Please upload a file in PDF format and use the naming convention "Last name-letters.pdf". You may include multiple letters in a single PDF file. Confidential letters of support may be submitted directly via email to grants@lungfund.org. File Size Limit: 2 MB Key Personnel* Provide a curriculum vitae or NIH biosketch of key personnel. Please upload a file in PDF format with the naming convention Last name-bios.pdf. File Size Limit: 3 MB Electronic Signature I certify that the statements herein are true, complete and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil or administrative penalties. I agree to accept responsibility for the scientific conduct of the project. Printed On: 13 April 2016 LCRF 2016 Grant Program 5
Principal Investigator's Signature* Please type your full name into the box below to electronically sign your application. Character Limit: 250 Today's Date* Character Limit: 10 Printed On: 13 April 2016 LCRF 2016 Grant Program 6