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Research Grant Application

The Alzheimer Society will consider applications for both monetary and non-monetary research support. Funds will be distributed through three distinct categories: research (max $15000), publication (max $2000) and, travel (max $1000)

The grant is available twice a year with the following deadline: April 1^st and October 15^th. For more information contact Nina Okopien at 519-759-7692 or by email nina.okopien@alzda.ca

Principal Investigator's Information
Name*
Phone*
Email*
Enter Email Confirm Email
Please Attach your Resume*
Project Information
Name of Research Project*
Have you previously applied for Alzheimer Society Research Support?*
When*
Were you successful in obtaining Alzheimer Society approval?*
Did you disseminate the results?*
Please describe dissemination activities in the space below*
Name of each Co-investigator*
Type of Research Support Request*
Does this proposed subject involve human or animal subjects?*
Can you provide confirmation that the proposal has been reviewed and approved, by an Ethics Committee of credible experts with arms-length relationship to the principal investigator?*
Please provide a lay description of the proposed project/study (max 250 words)*
Please describe the purpose and background rationale for the project, as well as the hypothesis or research question for the project/study*
Please describe all procedures in which research participants will be involved*
Please outline measures that will be used to protect confidentiality and anonymity of participants both during the conduct of the research and the dissemination of results*
Please be specific in terms of your expectations for involvement of Alzheimer Society staff*
Personnel: State the roles of research personnel and explain why you require the level (in terms of qualifications and salary) you are requesting*
Budget
Personnel cost*
Travel and Subsistence
Professional Services*
Professional Services cost*
Supplies and Other Expenses*
Other: Please itemize and explain each item*
Are you seeking funding for this project from other sources?*
Are there sponsoring organizations and sites involved in testing/research?
Please Elaborate*
Timeline
Date when the proposed project can be started if it is funded*
Date Format: MM slash DD slash YYYY
Duration of the proposed project*
Please elaborate on major tasks and completion dates (if a research grant please submit a project plan)*
Research products and plans for dissemination
Provide a clear indication of the expected outcome of the proposed research (e.g., publication in a journal, preliminary stage of a large project, how the project will lead to future funded research applications, etc.). Outline plans for the dissemination of results (max. 250 words):*
Is this part of a larger study?*
Please elaborate*
Please declare any conflicts of interest, benefits to the investigators.*

Research Grant Application

Principal Investigator's Information

Project Information

Budget

Timeline

Research products and plans for dissemination