Major Impact Project (MIP) – Poliomyelitis Research Foundation

Major Impact Project (MIP) Application

Closing Date: 28 February Of Each Year

Please note the following:

The PRF works to improve the health of the nation by supporting research into VIROLOGY.
Research grants are awarded to established researchers who have a track record of independent innovative research supported by a significant publication record.
This grant will only be awarded to applicants in possession of at least a PhD or equivalent degree.
The funding ceiling is R500 000 per annum for 3 years. A small number of Major Impact grants will be awarded each year for outstanding grant applications which have high impact value. Full and detailed motivation will be required as well as information proving the merit and high impact of the project.
The PRF must be acknowledged in all publications arising from a proposal funded by the PRF.
The deadlines for submission of applications must strictly be adhered to. Applications must arrive at the NICD on or before the deadline date. No late applications will be considered
Ensure that ALL sections of the form are completed and ALL requested information is attached.
After completion of your Major Impact Project (MIP) a Final Report Form MUST be submitted and can be downloaded from here. Please send the completed form to prf@nicd.ac.za

Grants Application Signatory Form

Please download the Grants Application Signatory form below and re-upload it in the relevant field in your application form after signing.

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General Information

Full NameName And Surname

Title

Race

OtherPlease provide details

Present Institution

Work AddressFull Postal Address

Contact Number

Emaila valid email

Institution NameFor Relevant Grant Cheque

Banking Details Of Relevant Institution

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Current QualificationsList your qualifications

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Present Professional Status

Relevant Work Experience To Date

Name Of Employer/Institution	Capacity And Type Of Work	Period
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Project Information

This section should include information relating to:

The Purpose of the research
The importance of the research
The background and feasibility of the project
A brief description of relevant information, the target population, hypotheses, and methodology
A brief description of methodology and expected results
A description of the contributions your research will make to the field of knowledge and health outcomes

Title Of Project

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Short Project Description

Short Project Description(Scientific abstract of project - 1000 characters max)

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Scope Of The Project For Which A Grant Is Requested (Proposed Research Programme And Plan Of Approach)

Brief review of published literature (max 20 references)

As a general rule, citations older than 10 years should not be used unless they are absolutely necessary in making the case for the proposed study or, if they are seminal works that should not be omitted.

Project Background and Rationale

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Specific ObjectivesPlease List Objectives Below

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Preliminary DataIf non available, please indicate "No Preliminary Data'

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Research Plan And Methodology

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TimelinesIndicate project tasks and timelines for completing each

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Details Of Research Team

Note: Please attach a SHORT CV of supervisor and Senior Members of the Research Team at the bottom of this application

Details Of Research Team

Name	Qualifications	Role	Time Devoted To Program
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Capacity Building

What Capacity Building Will Derive From This Project:Student(s) Info

Name	Degree	Funding Body
			×

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PRF Bursary Application Linked To This Application:Student(s) Info

Name	Degree
		×

(1)

Budget Details

Budget DetailsPlease ensure that unit costs and number of units are specified

Consumable Materials	Number Of Units	Unit Cost	Year 1	Year 2	Year 3
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Total Budget (Year 1 / 2 and 3)

OtherSpecify

Description	Qty	Price Per Unit	Total
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Total for Other

Capital Equipment

Items expected to last longer than three years

Description	Cost(VAT Inclusive)
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Total for Capital Equipment

Motivation For Purchase Of Equipment

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Budget Summary

Budget Summary(Please list Consumables, Other and Capital Equipment under "Type")

Type	1st Year	2nd Year	3rd Year
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Declaration Of Research Funding

Please Supply Details

Details of all other research funding received at present

Name Of Organistation	Project Title(Short)	Amount	Duration	Role In Project	Time Spent On Project
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(1)

Justify overlaping

NB: Any ommision or misrepresentation in this section could jeopardize this and future funding

Apart from your university/institution, are any other institutions concerned with the provision of facilities (which may include clinical material) neccessary for this research project? If yes, complete the table below

Name of University/Institution	Facilities required/provided
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(1)

Ethics Committee Certificate

NB: Your application will not be considered unless relevant ethics approval has been accepted.

Choose between Human And Animal for their relevant dropdown fields.

Please Provide Human Ethics Certification (PDF)max 2MB

Upload

Please Provide Animal Ethics Certification (PDF)max 2MB

Upload

Checklist: Please Complete / Attach

Upload Your
Supervisor CVmax 2MB

Upload

Upload CVs (Including
Publicationsmax 2MB

Upload

Quotes For
Equipmentmax 2MB

Upload

Grants Applicatoin
Signatory Formmax 2MB

Upload

Any Other Additional Information You Wish To Present, If Graphs, Please upload the graphs in a PDF doc as an annexmax 2MB

Upload

Brief Description of additional Data uploadedPlease provide a brief description of the additional data presented

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Quick Contact

Major Impact Project (MIP) Application

Closing Date: 28 February Of Each Year

Grants Application Signatory Form

Deadline Dates

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