Eli Lilly Specialist Research Grant Application Form 2008

							Eli Lilly Diabetes Specialist Research Award 2008
The award will recognise and support diabetes research in New Zealand by providing a grant to health professionals wishing to commence or continue a career of research in Diabetes Mellitus. It will take the form of a stipend of NZD $30,000 to permit the investigator to undertake research in the field of diabetes at a university or affiliated teaching hospital. The recipient will be announced and the funds will be available in August 2008.

Applications close 30th June 2008
For further details please contact Barbara Critchlow at:

Eli Lilly and Company (NZ) Limited Phone: (09) 523 9308 Free Phone: (0800) 500 909
To receive a word document version, please email: Email: bcritchlow@lilly.com

To assist you, a “Guide to Applicants” and an application form are attached. Four (4) copies of the completed application marked CONFIDENTIAL must be lodged no later than Monday 30th June 2008 at the following address: The Administrator Eli Lilly Diabetes Research Grant P.O. Box 109197 Newmarket AUCKLAND, 1149

Eli Lilly Diabetes Specialist Research Award 2008

Guide to Applicants
1. Grants will be paid ONLY to a university, public hospital or other institution concerned with the promotion of medical research. Grants to individuals will be made only through a recognised institution. The principal investigator must be a paid up member of NZSSD of not less than two years standing. (at least since 2006) 2. Projects should be submitted in such a way that the specific relationship to diabetes mellitus is made clear. The applicant should state whether this project is directed towards the complications of diabetes. Particulars of proposed project should include:
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3.

4.

Applicant details: name, address, age, appointment, academic qualifications and experience Full CV for applicant and short CV for all investigators Title of project Duration of project Location of project Details of proposed undertaking The financial resources available for this project and related projects, plus particulars of other applications made or to be made for assistance. Name and address of institution to which allocations should be paid. Total length/excluding CVs less than 6 sides of A4.

Grant will be judged by NZSSD Executive Grants Committee. It will be required that recipients will submit annual progress reports to NZSSD Executive one and two years after receipt of the Grant. They will also be required to present their work at the Annual NZSSD scientific conference, on completion of their project. Adherence to these requirements will be taken into consideration when assessing applications from previous recipients of this award.

5. Four (4) copies of the application marked CONFIDENTIAL should be submitted to: The Administrator Eli Lilly Diabetes Research Grant P.O. Box 109197 Newmarket AUCKLAND, 1149

Eli Lilly Diabetes Specialist Research Award 2008

Application Form
Closing date 30th June 2008
Please complete this form and send four (4) copies of your full application, marked CONFIDENTIAL to: Attention: The Administrator Eli Lilly Diabetes Research Grant P O Box 109197 Newmarket Auckland, 1149

1.

Applicant Details Name: Title: Contact Address:

Phone: Fax: Full CV attached: Supervisor (if applicable): Name: Title:

2.

Project Details Title:

Duration: Location: Project Description: (400 - 600 words)

______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

Details of other sources of funding applied for/available for this project and related projects. ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

3.

Ethics/Scientific Committee approval granted: (attach if Yes)

Yes No

Pending N/A why not?

4.

Name and address of institution to which any allocations would be paid: ______________________________________________________________

_ ______________________________________________________________ _ ______________________________________________________________ _ ______________________________________________________________ _ ______________________________________________________________ _ ______________________________________________________________ _

Final Application Checklist:

All details on application form completed

Full CV for applicant and short CV for ALL investigators attached

Details of previous work (related to this project) and list of relevant publications, if not included in CV