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BRC3 Gastroenterology and Mucosal Immunology

Response mode internal funds

Application Form:

 (Print out and fill in form shown below or contact Carolina Arancibia (mailto:carolina.arancibia@ndm.ox.ac.uk)

 Principal Investigator

Name, position and contact details (email and telephone number) of lead applicant:

 

University department and unit:

 

Co-Applicants

Name, position, University department and Division of all co-applicants:

 

Project details

Title:

 

Start date:

 

End date:

 

Financial details

Total direct cost of the research project:

 

Contribution to direct costs from Department/Faculty/Division:

Please give details including specific source(s)

 

Contribution from other sources:

Please give details including specific source(s)

 

Amount requested from the Fund:

 

Breakdown of funds requested

Budget heading

Description

Amount requested

Staff costs

 

 

Consumables

 

 

Equipment

 

 

Other direct costs

 

 

Total

 

 

Lay Person Summary (no more than 250 words)

 

Ethical review status

Does the project require ethical review?

 Yes       If you have a CUREC number approved for this project please provide it here:

   If not, you must obtain a number before the project can start

 No    

Approval by host department Departmental Administrator 

Name

 

Signature

 

 

 

I confirm that the Department has approved this application and that the appropriate ethical approvals, and personal and project licenses for the project will be in place before the project starts.

I also confirm that the applicant holds a contract extending until at least the end date of their proposed project (or a departmental underwrite). 

Administrative contact for award

Name, position and contact details of administrative contact:

 

Please append the following to your application:

  1. Case for support (see template overleaf)
  2. A one page CV for each applicant listed in the application form
  3. An X5 costing admin output for your project, this does not need to be submitted to Research Services
  4. A letter of support from the Head of the host department

Case for Support

Please complete the following sections in non-technical language comprehensible to a general academic audience (rather than to subject specialists only). The case for support must be a maximum of 2 sides of A4 (minimum 11 point font).

Lead Applicant

 

Title of Post

(e.g. University Lecturer)

 

Project Title

 

Abstract                                                                                                                    (max 250 words)

 

Justification for support

 

Project objectives and proposed outcomes                                                                                 

 

Additional supporting material

List of external research grants held (if applicable)           (This is additional to page limit above)
  1.  
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