MULTIPLE SCLEROSIS RESEARCH AUSTRALIA

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					                                              Multiple Sclerosis Research Australia

                                                  POSTDOCTORAL FELLOWSHIP

                                                       2011 APPLICATION
Eligibility
The MSRA Postdoctoral fellowship is open to those candidates who have qualified or are in the last year of their
PHD studies. The applicants must have completed their PhD within the last twelve years. The duration of the
Postdoctoral fellowship is typically three years. This may vary. Typical Grant-in-Aid amount
be $70-80,000 per year. This too may vary from year to year. Successful applicants will be required to submit a
Progress Report and Financial Statement report in March of the next calendar year, following each year of research
completed.

Instructions to Applicants
Prior to completing this application please acquaint yourself with the contents of the Conditions of Award and Funding
Process documents which are available from the Multiple Sclerosis Research Australia (MSRA) website. Please address
your queries to the Research Coordinator, Heather Cato (contact details below).

MSRA provides Postdoctoral Fellowships to support research into the causes, cure and management of MS.

    1. If you wish to apply for a MSRA Postdoctoral Fellowship first obtain a number from the Research Coordinator at
       email grants@msra.org.au ahead of the closing date. Please provide your name, application title and indicate
       separately if your application is in biomedical, social or applied research. The number will be emailed to you and
       must be used on your application and all correspondence.
    2. Please arrange for the supply of three (3) Referee Reports. The Referee reports are welcome electronically but
       must be generated from the Referee’s email address and emailed directly to the MSRA Research Coordinator by
       the required closing date.
    3. All Postdoctoral Fellowship applications must be submitted using this application form. Applications not submitted
       on this form will be ineligible for consideration. In terms of format, printing options must be set to single side and
       the font setting used should be Arial Narrow 11. Please delete this covering page before you submit your
       application. Applications should be submitted as both PDF and a MS Word document.

    4. The closing date for electronic (PDF and MS Word) submission of your Postdoctoral Fellowship application to
       grants@msra.org.au is April 12th 2011. Additional to this, one paper copy of the application with original signatures
       must be provided and should arrive at the address below by April 19th.2011. Please note that your institution may
       have an earlier closing date.

Heather Cato
Research Coordinator
MS Research Australia (MSRA) Perth Office
Department of Neurology and Neurophysiology
Sir Charles Gairdner Hospital
Nedlands WA 6009 Australia
Tel: +618- 9346 2471 / 08-9389 9680
Email: grants@msra.org.au Web: www.msra.org.au

Information contained in applications is regarded as confidential, unless otherwise stated, and will be received and
treated as confidential by MSRA.
                                                       Multiple Sclerosis Research Australia

                                                         POSTDOCTORAL FELLOWSHIP

                                                            2011 APPLICATION FORM

Please enter the number assigned to this Postdoctoral Fellowship
obtained from the MSRA Research Coordinator. Email:                           1     1
grants@msra.org.au

Indicate whether your application is biomedical, social or applied


1. Funding institutions also approached. Please note that there is no               Yes/No     NHMRC #
automatic routing of applications between the NHMRC and MSRA

1.1 Are you applying for a Early Career or Career Development award?, Is it the
same grant application as this? If yes, please provide the NHMRC number of
your application. Please note that there is no automatic routing of applications
between the NHMRC and MSRA. Please also refer to section 16.3
1.2 If not applying, please advise reason below

1.3 Are you applying for a NMSS Postdoctoral Fellowship? If yes, and it is the same application as this,
which grant round are you applying in? Please note that there is no automatic routing of applications
between the NMSS and MSRA

1.4 Will the research be conducted in Australia? Please indicate %. Please note that, ordinarily, MSRA will
not fund research conducted outside of Australia. Circumstances will be considered.



2. Applicant details (Please insert your signature in Section 20.1)

2.1 Full name
2.2 Title
2.3 Date of birth
2.4 Highest degree conferring institution and year
obtained
2.5 Current appointment
2.6 Current work address in full
2.7 Telephone - Office
2.8 Telephone - Mobile
2.9 Email address
2.10 Working time (%) to be devoted to this project
2.11 Working time (%) to be devoted to all other
research projects
2.12 Dates of anticipated absence during the
fellowship period
2.13 Citizenship:
     (a) If you are not an Australian citizen, has a
permanent resident status or a Special Category


Insert fellows name here.       2011 Postdoctoral Fellowship Application                       Page 2 of 9
Visa been sought?
    (b) Has permanent resident status or a Special
Category Visa been granted?


3. Supervisor (Signature of Supervisor to be inserted in Section 20.2)

3.1 Full name
3.2 Title
3.3 Institution name
3.4 Institution address
3.5 Telephone no
3.6 Email address


4. Location of the Project (Signature of Head of Department to be inserted in Section 20.3)
4.1 Department
4.2 Institution name
4.3 Institution address
4.4 Telephone number
4.5 Email address


5. Administering Institution (Signature of Responsible Officer to be inserted in Section 20.4). The
administering institution is responsible for submitting invoices and providing an annual audited account to
MSRA if the applicant ‘s application is successful

5.1   Name of Responsible Officer
5.2   Full address
5.3   Phone no
5.4   Email address


6. Project Details

6.1 Scientific Title


6.2 Key Words
List 10 key words describing your application.

6.3 Lay Title
Must be easily understood by the general public. Please avoid using specialist terms.

6.4 Lay Summary
Must be easily understood by the general public. Please avoid using specialist terms. Do not include a
definition of MS, as this is available widely. This will be published on the MSRA website if your application
is successful.




Insert fellows name here.      2011 Postdoctoral Fellowship Application                        Page 3 of 9
7. Relevance to Multiple Sclerosis

Explain in detail exactly how your project contributes to advancing the understanding, treatment or
management of MS.



8. Aims and Significance of Project

8.1 Aims
Describe the specific aims of the project.

8.2 Hypotheses
State clearly the hypotheses to be tested. The Project must be hypothesis driven.

8.3 Significance



9. Background

Clearly describe the background of the project including
     Scientific aspects and any other relevant material
     The planned outcome of the research plan
     The potential significance of the research



10. Preliminary Data and Experimental Expertise (maximum of six (6) pages). Unless preliminary data is
fully evident you may want to consider applying for a MSRA Incubator Grant. Your grant will be considered
competitive only if there is strongly cogent preliminary evidence.

Clearly and specifically indicate preliminary data obtained
     Describe any preliminary data against each aim
     Describe available expertise in techniques relevant to the realisation of your research plan



11. Research Plan (maximum of six (6) pages)

Complete the following for each aim listed in section 8.1 including:
    A detailed description of the experimental design
    Techniques to be used
    Sample size(s)
    Methods of statistical analysis
    Specify timeline or major time allocations
    Please provide a high level timeline with anticipated measurable major review points.




Insert fellows name here.       2011 Postdoctoral Fellowship Application                     Page 4 of 9
12. References (maximum of six (6) pages).

Indicate key references (up to 6) with asterisks
MSRA will not progress your application unless key references are denoted by an *
Please provide a list of references cited in:
      Section 9 Background
      Section 11 Research Plan


13. Budget

           Please supply a budget for each year of funding sought
           Personnel costs. Always include on-costs and specify percentage % on-costs used
           Specify any consumables and maintenance without GST
           Provide separate totals at the end of this section for personnel and any consumable costs
           Provide a grand total by year

13.1 Justification of budget

By item



14. Ethical Considerations. Successful projects must provide evidence of full institutional ethical approval
before the commencement of the first funding year.
For experiments involving humans or animals give a brief statement of the ethical issues that arise from
such experimentation and an explanation of how you will address these issues.



15. Clearance Requirements.

15.1 Human Experimentation
This includes research involving any human tissue, no matter what the source, administration to humans of
drugs, chemical agents or vaccines and any physical or psychological intervention in the normal lives of
humans. Any human experimentation shall be conducted in accordance with the current requirements of the
NHMRC Statement on Human Experimentation and Supplementary Notes.

15.2 Animal Experimentation
Experiments involving the use of animals shall be conducted, and experimental animals shall be housed,
maintained and controlled, in accordance with the current NHMRC document ‘Australian code of practice for
the care and use of animals for experimental purposes' and any additional Supplementary Notes adopted by
the NHMRC. For inbred strains of animals, state date on which genetic authenticity was last checked.

15.3 Use of radioactive substances, ionising radiation, recombinant DNA, potent teratogens or
carcinogens
Clearance for projects involving any of the above must be obtained from the appropriate
Institutional Biosafety Committee and/or where relevant the Institutional Ethics Committee.

15.4 Intention to use MS tissue from the MSRA Brain Bank (MSRABB). If your project is funded and
requires MSRABB tissue, then a request must be made to the MSRABB Scientific Advisory Committee,


Insert fellows name here.      2011 Postdoctoral Fellowship Application                       Page 5 of 9
www.msbrainbank.org.au. When MSRABB approval for tissue and full institutional ethical approval has been
received, please send a copy of the approval letters to the MSRA Research Coordinator.
                                                                                     Yes          No
(a) Are you planning to request MS Tissue from the MSRABB?
(b) If yes, indicate approximate timing (MM/YY)


16 Research Support. Itemise for all Applicants

16.1 Past Support (over the previous 6 years)
Complete the following information for each grant that you have been previously awarded
     Funding Agency
     Project Title
     Names of all investigators
     Value of support for each year
     Start year and end year of support


16.2 Current Support
Complete the following information for each item of support you are receiving.
     Funding Agency
     Project Title
     Names of all investigators
     Value of support for each year
     Start year and end year of support


16.3 Other applications for funding sought for this fellowship excluding those described in section
1.
Complete the following information for each other application you have made this year for fellowship funding
     Funding Agency
     Project Title
     Names of all investigators
     Value of support for each year
     Percentage overlap with this project is applicable.




17. Publications. Starting with the most recent publication.

         List all papers that have been published in refereed journals in the last 5 years which relate directly
          to the research topic of your fellowship Application...



18. Curriculum Vitae

Please attach a full CV.



Insert fellows name here.        2011 Postdoctoral Fellowship Application                         Page 6 of 9
19. Referee Reporting. Please complete information below for each of the three (3) referees you will expect
to supply a reference.
       Referees should be asked to email a report from their email address, in confidence to Heather Cato
          at the MSRA Research Coordinator (grants@msra.org.au)
       Referees should comment on the fellow’s research ability, academic performance, personal
          qualities and suitability for a postdoctoral fellowship.
       These reports will remain confidential to members of the MSRA Research Management Council
Name
Position
Institution
Email

Name
Position
Institution
Email

Name
Position
Institution
Email


20. Certification by Applicant, Supervisor, Head of Department and Administration Office.

20.1 Insert Scanned Signature of Applicant

In signing/scanning your signature on this page, you certify that all details given in this application are
correct and you agree to undertake the Postdoctoral Fellowship according to the role and responsibilities
defined in the application.

Name ………………………………………………….. Date: ……………………….


Signature: ……………………………………………………………………………….

20.2 Insert Scanned Signature of Supervisor

I certify that should ……………… (Insert applicant’s name) ........................……..

Receive a MSRA Postdoctoral Fellowship I undertake to make available facilities as required.

Name ………………………………………………….. Date: ……………………….


Signature: ……………………………………………………………………………….

20.3 Insert Scanned Signature of Head of Department



Insert fellows name here.       2011 Postdoctoral Fellowship Application                       Page 7 of 9
I certify that should ……………… (Insert applicant’s name) ........................……..

Receive a MSRA Postdoctoral Fellowship I undertake to make available facilities as required.

Name ………………………………………………….. Date: ……………………….


Signature: ……………………………………………………………………………….

20.4 Insert Scanned Signature of Administrative Officer

I certify that should ……………… (Insert applicant’s name) ........................……..

Receive a MSRA Postdoctoral Fellowship I will ensure that all necessary ethics clearances have been
obtained and supply confirmation and evidence to the MSRA Research Coordinator.

Name ………………………………………………….. Date: ……………………….


Signature: ……………………………………………………………………………….

20.5 Insert details of and scanned signature of the contact at your institution who will receive
notification of the outcome of this application.

I certify that should ……………… (Insert applicant’s name) ........................……..

Receive a MSRA Postdoctoral Fellowship this office will arrange for the collection, recording and distribution
of the funding on behalf of the Project.

Name ………………………………………………….. Date: ……………………….


Signature: ………………………………………………………………………………..

Email address ………………………………………………………………………….



21. Nomination of external assessors. List three (3) assessors who you deem as having the necessary
expertise to independently assess your application. These persons must not have any association with this
research project. Copy for each assessor.
Name
Institution
Email address


22. Exclusion of external assessors. List external assessors who you do not wish to review your
application. This section can remain blank.
Name
Institution
Email address
Reason

Insert fellows name here.       2011 Postdoctoral Fellowship Application                       Page 8 of 9
Thank you for completing the MSRA Postdoctoral Fellowship Application.
We wish you every success.




Insert fellows name here.     2011 Postdoctoral Fellowship Application   Page 9 of 9

				
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