… · web view · 2017-04-28registered charity: 516898. yorkshire cancer research is a company...

Deadline: 12 noon Thursday 15 th June 2017

Applications must be sent in Microsoft Word format to [email protected]. PDFs will not be accepted. Please use the filename format “[SURNAME] – 2017 FULL APPLICATION”. Please also submit 15 double-sided hard copies to arrive by the deadline above. If your application is successful in the Strategic Fit Assessment we will require you to provide additional hard copies.

PRIVACY STATEMENT

For full details on how we use your information please visit www.ycr.org.uk/privacy.

BEFORE YOU BEGIN

PLEASE EMAIL [email protected] TO ARRANGE A CALL TO DISCUSS THE SCOPE OF YOUR PROJECT.Check this box to confirm that you have been advised by the Charity that your application is in scope for this funding round. Applications submitted without this consultation will not be eligible.Check this box if you have sought advice from a relevant Clinical Studies Group.

Check this box if have you consulted with NIHR Clinical Research Network Yorkshire and Humber about this proposal.

Check this box to confirm that you have read the checklist at the end of this application.

Check this box to confirm you have read the Information for Applicants, Award Conditions and Policies for Awards.

SECTION 1PRINCIPAL APPLICANT’S DETAILS

Please complete in Calibri font size 10

Principal Applicant

Current Post & %FTE % FTE on this project

Will your CURRENT employment extend beyond the end date of this

project? If no, give the end date.

Principal Applicant phone number

Principal Applicant email address

Host Organisation / Department

Postal address

Town/City Postcode

Signature(All applicants MUST sign)

Electronic signature

PERSONAL ASSISTANT DETAILSPersonal Assistant name

Personal Assistant email

Personal Assistant phone number

Registered Charity: 516898. Yorkshire Cancer Research is a company limited by guarantee registered in England, number 1919823.Registered Office: Jacob Smith House, 7 Grove Park Court, Harrogate HG1 4DP

1

2017 Funding Round“Tackling Yorkshire’s Cancer Problems”

APPLICATION FORM

mailto:[email protected]

http://www.ycr.org.uk/privacy


2Registered Charity: 516898. Yorkshire Cancer Research is a company limited by guarantee registered in England, number 1919823.

Registered Office: Jacob Smith House, 7 Grove Park Court, Harrogate HG1 4DP

LAY REPRESENTATIVE

Lay Representative Email/phone number

Check this box to confirm the lay representative has given permission for their contact details to be provided to us.

Lay representative guidance can be found in the Information for Applicants document

SECTION 1CO-APPLICANTS’ DETAILS

Surname Forename Title click titleCurrent Post & %FTE % FTE on this project

Will your CURRENT employment extend beyond the end date of this project? If

not, give the end date.

Co-applicant email address



Surname Forename Title click title






























SECTION 1CO-APPLICANTS’ DETAILS

Surname Forename Title click titleCurrent Post & %FTE % FTE on this project

Will your CURRENT employment extend beyond the end date of this project? If not, give the end date.






























SECTION 2ABOUT YOUR PROJECT

Project title

Proposed start date (dd/mm/yyyy)

Project length (months)

Which funding priority does your project address?

Living with and beyond cancer 1. Preventing recurrence and promoting better quality of survival for people living with

and beyond cancer in Yorkshire 2. Interventions to address inequalities in access to survivorship services 3. Living with and managing advanced cancer

Early diagnosis 4. Interventions which improve the awareness of cancer signs and symptoms, and

translate this awareness into action, targeted towards at risk populations 5. Developing and delivering interventions that can achieve a significant

stage shift in diagnosis 6. Addressing variations in cancer screening uptake at a local level

Clinical trials 7. Expanding clinical trials in Yorkshire for wider-scale patient benefit

Total amount requested

Click on the grey boxes below and choose from the drop down list

Is your current research supported by other funding

bodies?

Click on Yes/No If yes please give organisation details and award value.

Are you currently applying elsewhere for support for work

relating to this project?

Click on Yes/No If yes please give organisation details and expected outcome date.

Is this application or any part of it currently being submitted

elsewhere?

Click on Yes/No If yes please give organisation details and expected outcome date.

Does this application follow on from a previously funded

Yorkshire Cancer Research award?

Click on Yes/No If yes please give award number and details.

Is this a full or partial resubmission of a previous

application to Yorkshire Cancer Research?

Click on Yes/No If yes give date and funding round. Please note that resubmissions are only eligible if specifically invited.

Are you considering applying for NIHR portfolio status for your

study?

Click on Yes/No If yes give details on relevant discussions about portfolio adoption.

Will animals be used in this project?

Click on Yes/No Please note that pre-clinical work is unlikely to be in scope for the 2017 Funding Round. See Information for Applicants for further details.




Project summary in lay terms – i.e. for press releases or newsletters to the general public (100 words MAX)

Word count

Technical summary (100 words MAX)

Word count

What need does your project address? (150 words MAX)

Word count




What impact will your research have on cancer patients and/or cancer outcomes in Yorkshire? (150 words MAX)

Word count

If this research is successful what is the timescale until patient/public benefit is realised and what are the key milestones towards achieving this benefit? (150 words MAX)

Word count

Will this project involve members of the public, patient samples or use of patient data? If yes, please give the number of people and/or samples.



SECTION 2PROJECT MILESTONE DIAGRAM

Please provide a diagram (eg Gantt chart) with a graphical representation of the project milestones.



SECTION 2PATIENT/PUBLIC BENEFIT DIAGRAM

Please provide a diagram with a graphical representation on delivery of patient/public benefit. Please ensure you indicate whether this is anticipated during and/or beyond the timeframe of the Award itself.



SECTION 3FULL PROJECT DESCRIPTION

Projects ≤ £350k Projects > £350kCombined project background and detailed plan MAX 2500

words plus up to 5 tables/figuresCombined project background and detailed plan MAX 15

pages including figures/tables

Project backgroundPlease complete these sections in Calibri font size 10 with 1.5 line spacing

SECTION 3FULL PROJECT DESCRIPTION



Detailed project plan Including: 1) milestones 2) cost justifications and 3) if your work has statistical analyses, relevant power calculations.

Word count (or page count for larger applications)

SECTION 3REFERENCES AND SUPPORTING LITERATURE

Please list each reference in number order.



Why are you and your team well placed to deliver the objectives of this project? (100 words MAX)



Word count

SECTION 4RESEARCH OUTPUTS AND INTELLECTUAL PROPERTY

What plans are in place to protect or commercialise any research output(s) including intellectual property? (100 words MAX)

Word count



SECTION 5PROJECT COSTINGS

PLEASE CONSULT THE INFORMATION FOR APPLICANTS DOCUMENT BEFORE STARTING THIS SECTION

SALARY REQUESTED FOR APPLICANTS AND STAFF

ONLY include salaries of applicants when they are a directly incurred cost of this project (see Information for Applicants)

Staff costings (including NI and superannuation)

Name and job title Grade and %FTE Year 1 (£) Year 2 (£) Year 3 (£) Year 4 (£) Year 5 (£) TOTAL (£)

TOTAL SALARY COSTS

IF COSTINGS ARE NOT TOTALLED ACCURATELY YOUR APPLICATION MAY NOT BE CONSIDERED

NON-SALARY PROJECT COSTS

Please see Information for Applicants for our costing policyIndividual costs of £3000 or over must be itemised and/or a quote provided

Cost details Year 1 (£) Year 2 (£) Year 3 (£) Year 4 (£) Year 5 (£) TOTAL (£)

TOTAL COSTS

IF COSTINGS ARE NOT TOTALLED ACCURATELY YOUR APPLICATION MAY NOT BE CONSIDEREDSUMMARY OF TOTAL COSTS

Total salary costs PLEASE CONFIRM YOU HAVE CHECKED YOUR COSTINGS (E.G.

IN EXCEL)Total non-salary project costsOVERALL TOTAL

(must match total provided in Section 2) Yes/No

IF COSTINGS ARE NOT TOTALLED ACCURATELY YOUR APPLICATION MAY NOT BE CONSIDERED



SECTION 6APPLICANT EXPERTISEPRINCIPAL APPLICANT

Surname Forename

Relevant qualification Subject Grade Organisation Date

Relevant posts held (include job title) Organisation Date

Please describe your track record in delivering outcomes related to the proposed work (150 words MAX)

Word countPlease provide details of up to 5 of your recent publications (please include titles)

Applicants for projects >£350k may supply all relevant publications

Registered Charity: 516898. Yorkshire Cancer Research is a company limited by guarantee registered in England, number 1919823.Registered Office: Jacob Smith House, 7 Grove Park Court, Harrogate HG1 4DP

16

COPY THIS PAGE FOR ADDITIONAL CO-APPLICANTS AND RENUMBER

CO-APPLICANT 1Surname Forename





Co-Applicants for projects >£350k may supply all relevant publications



COPY THIS PAGE FOR ADDITIONAL STAFF MEMBERS AND RENUMBER

ADDITIONAL STAFF 1Surname Forename





Staff members for projects >£350k may supply all relevant publications



SECTION 7PREVIOUS YORKSHIRE CANCER RESEARCH AWARDS

THIS SECTION IS ONLY FOR CURRENT OR PREVIOUS YORKSHIRE CANCER RESEARCH AWARD HOLDERSPLEASE COPY THIS PAGE FOR ANY ADDITIONAL AWARDS

Please complete if any applicant on this project has been a Principal Applicant on a Yorkshire Cancer Research award with a start date within the past five years.

Project title and award reference

Project start date (DD/MM/YYYY) Project end date (DD/MM/YYYY)

Award holder(s)

Brief summary of project impact including advancement of knowledge, contribution to clinical practice, commercial exploitation and career development

Peer reviewed research papers directly resulting from this award (full academic citation)

Page number where Yorkshire Cancer Research is acknowledged

Please indicate whether research papers have been submitted to [email protected] . Please provide Yorkshire Cancer Research disclosure reference number(s) or any IP opinions from Yorkshire Cancer Research with relevant dates.

Have either of the following been provided? If so, please give relevant dates.

1) Annual Reports

2) KPI reports




SECTION 8PREFERRED REVIEWERS

Applicants must name AT LEAST 2 and up to 4 preferred reviewers from OUTSIDE YORKSHIRE.Those who have co-published with ANY applicant within the past 3 years are not eligible.

Reviewer 1

Name Email Tel

Organisation

Expertise

Reviewer 2

Name Email Tel

Organisation

Expertise

Reviewer 3

Name Email Tel

Organisation

Expertise

Reviewer 4

Name Email Tel

Organisation

Expertise

SECTION 8EXCLUDED REVIEWERS

Applicants may name up to 2 EXCLUDED reviewers from OUTSIDE YORKSHIRE

Excluded reviewer 1Name Email

Organisation

Excluded reviewer 2Name Email

Organisation



SECTION 9ACCEPTANCE OF AWARD CONDITIONS AND POLICIES FOR AWARDS

I/We shall be actively engaged in, and in day-to-day control of, the project. I/We have read The Charity’s current Award Conditions and Policies for Awards. If my/our application is

successful I/we agree to abide by them.

Signature of Principal Applicant Electronic signature

Date

This application MUST be submitted via the Principal Applicant’s Line Manager or Head of Department AND the officer responsible for administrating any award granted.

Each should sign the following declaration:

I confirm I have read the application and that, if awarded, the work will be accommodated and administered in the Organisation/Department in accordance with the Award Conditions and Policies for Awards.

The staff gradings and salaries quoted are correct and in accordance with the normal practice of this Organisation.

HEAD OF DEPARTMENT/LINE MANAGERTitle click title Name

Job title

Organisation

Postal Address

Address line 1

Address line 2

Town/City

Postcode

Phone number Email

Signature Electronic signature Date(dd/mm/yyyy)

ADMINISTRATIVE AUTHORITYTitle click title Name

Job title

Organisation

Postal Address

Address line 1

Address line 2

Town/City

Postcode

Phone number Email

Signature Electronic signature Date(dd/mm/yyyy)

SECTION 10COMMUNICATIONS



By completing the section below we can keep you up to date with our latest news about the work we do, the research we fund and other ways you can get involved, including fundraising. We promise never to share your personal

information with any other organisation outside of Yorkshire Cancer Research for their marketing purposes.

You can unsubscribe at any time by contacting [email protected] or calling 01423 877229.

For full details on how we use your information please visit www.ycr.org.uk/privacy.

Please tick the relevant boxes below to indicate your preferences about being contacted in the future.

PLEASE NOTE: Even if you already receive our research newsletter or other Yorkshire Cancer Research news, you must again confirm here your permission for us to send you this information due to changes in fundraising

regulations and data protection.

Applicant name

If you would like to receive our funding

announcements and research newsletter, please

tick here.

If you would like our latest news about other ways you can get involved including fundraising,

please tick here.

Lay representative name



http://www.ycr.org.uk/privacy


CHECKLIST FOR APPLICANTS – PLEASE COMPLETE BEFORE SUBMITTING YOUR APPLICATION

Have you read the Information for Applicants, Award Conditions and Policies for Awards?

Have you consulted with a member of the Research and Innovation team to determine whether your application is in scope for this Funding Round?

Have you consulted with a relevant Clinical Studies Group?

Have you consulted the NIHR Clinical Research Network Yorkshire and Humber team to discuss NIHR portfolio adoption and potential CRN support for your study?

Have you completed all sections of the application form?

Have all the applicants signed Section 1? Have applicants provided employment end dates if they fall before the end of the project?

Have you had a Patient or Lay Representative read and comment on the application and particularly the project lay summary? Do you have permission to provide their contact details to Yorkshire Cancer Research?

Have you checked that all amounts in Section 5 have been added up correctly? We recommend using Excel to ensure totals are correct. Are only direct project costs included? Have you provided a breakdown for any costs over £3000?

Applications with costings that do not add up correctly may not be considered

Has the form been signed by the Head of Department/Line Manager and the appropriate Organisation Administrative Authority in Section 9?

Have all applicants completed Section 10 on communication preferences?

Have you ensured that you have not altered the format of the original application form? Note that applications must conform to the word count and formatting rules where indicated.

The only additions allowed to the application are notices of ethical approval, letters signifying collaboration and quotations for costings which you can include at the end of the application or send as attachments in PDF format. Manuscripts and papers may be sent to accompany the application as PDF attachments if they have been accepted for publication and they are not available in the public domain. Please also send 15 hard copies of any supplemental material. Please note if your application passes the Strategic Fit Assessment you will be asked to provide further hard copies of the supplementary material.

Have you printed and signed the original application form? (electronic signatures are accepted). In addition to this have you sent 15 double-sided photocopies to Jacob Smith House, 7 Grove Park Court, Harrogate, HG1 4DP? Hard copies must also be received by the application deadline. If your application is successful in the Strategic Fit Assessment we will require you to provide additional hard copies.

Have you emailed a copy in Microsoft Word format to [email protected]? Application forms in PDF formats will not be accepted. Please name the file in the following format “[SURNAME] - 2017 FULL APPLICATION”.

Please do not submit an application if you answer “no” to any of the above questions. If you do not receive an acknowledgement within 7 days of submitting your application please

contact [email protected] or phone 01423 501269.





http://yorkshirecancerresearch.org.uk/for-researchers/award-policies-and-conditions/

http://yorkshirecancerresearch.org.uk/wp-content/uploads/2017/04/Information-for-Applicants-2017.pdf

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