- AIRC -
Associazione Italiana per la Ricerca sul Cancro
PROPOSAL FORM 2006
Via Corridoni, 7 - 20122 MILANO
tel.02/7797206-217-275 - fax 02/7797259
per informazioni tecniche tel.02/7797224
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ASSOCIAZIONE ITALIANA PER LA RICERCA SUL CANCRO
Grant Proposal 2006
TITLE PAGE
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Principal Investigator's full Name and Qualification
Proposal Title
Basic/Translational Research
Clinical Epidermiological Research
Type of Grant
Budget 2006 (euro):
Keyword 1
IG
Estimated budget 2006 - 2008 (euro):
Keyword 2
Keyword 3
Ente/Università
Dipartimento/Istituto/altro
Indirizzo
Città + ZIP Code
()
Telefono
E-mail
Fax
Authorized Administrative Official
Address
City + ZIP Code
()
Phone
E-mail
Proponent's signature
Authorized Administrative Official's signature
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Fax
Date
04/11/2005
Date
04/11/2005
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EVALUATION FORM (selection 2000-2005)
Principal Investigator's Full Name
Total Papers and Reviews
0
Average IF
0
Total IF
0
Papers First/Last or Corresponding Author
0
Average IF
0
Total IF
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0
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INVESTIGATOR'S STATEMENT (for New Unit Start-Up Grants only).
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INSTITUTIONAL COMMITMENTS (for New Unit Start-Up Grants only).
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PROPOSAL MAIN BODY
ABSTRACT
Principal Investigator's Full Name
Institution and City
Proposal Title
Keywords
(1 page)
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ANNUAL REPORT
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PROPOSAL MODIFICATIONS (only for proposals refused in 2005).
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PROPOSAL RELEVANCE STATEMENT.
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BACKGROUND AND RATIONALE.
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DESCRIPTION OF THE PROPOSED RESEARCH.
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FEASIBILITY OF THE PROJECT.
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PERSONNEL INVOLVED IN THE RESEARCH
Name
Total Man/Year on project
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Date of birth
PI
Role on project
Fellowship
Required
Effort on
project
Man/year
effort
0
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DESCRIPTION OF THE WORK FOR EVERY UNIT OF PERSONNEL.
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BUDGET FORM
Research costs
Fellowships
Indirect costs
Subtotal
Overhead
Total
2006
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
2007
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
2008
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
Total
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
0,00 €
Justificatons
RESEARCH COST
FELLOWSHIPS COST
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BIOGRAPHICAL SKETCH
Name
BIOGRAPHICAL SKETCH
Position
Date of birth
Education and Training (include degrees and post-doctoral training)
Institution and Location
Degree
Year (from/to)
Field of Study
RESEARCH AND PROFESSIONAL EXPERIENCE
Year (from/to)
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Institution
Position
City
Country
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PUBLICATIONS
Listed, in chronological order, are title, all authors, and complete reference of all publications 1998-2005.
Principal Investigator's Full Name:
Authors
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Title
Journal
Year
Vol.
Nr.
Pages
IF
F/L
Relevant
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EXISTING/PENDING SUPPORT
Funding Agency
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Project Title
From
To
Amount
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EXISTING/PENDING SUPPORT JUSTIFICATION
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SUGGESTED REVIEWERS
Undesiderable reviewers
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BIO-ETHICAL REQUIREMENTS
Does the proposed research involve:
HUMAN EXPERIMENTATION
YES
NO
X
Human experimentation includes involvement of human subjects and other issues with ethical implications.
If yes include clearance from the competent ethical committee (as addendum E). If approval of the ethical committee is not available at
moment of submission, include as addendum E, a signed statement from the proponent pledging to obtain it before the start of the
research. AIRC will not erogate funds in the absence of an ethical committee clearance.
ANIMAL EXPERIMENTATION
YES
NO
X
If yes the following statement will have to be signed in the paper submission:
The Ethical Committee for animal use in cancer research has evaluated the proposal.
The Committee considers that the preliminary results, obtained in in-vitro experiments deserve a preclinical study.
The procedures related to animal use are accurately described in the proposal and conform to all regulations protecting animals used for
research purposes, including those of the DL 116/92. The experiments described in the proposal will be performed following the detailed
Internal Regulation drawn-up according to: Workamn P., et al. (1998) United Kingdom Coordinating Committee on Cancer Research
(Guidelines for the welfare of animals in experimental neoplasia. Br. J. Cancer 77: 1-10).
Date:
04/11/2005
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Name of PI
Signature
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ADDENDA
Addendum A: Letter of the NUSUG sponsor (uploaded as PDF file)
Addendum B: 2 copies of up to 5 papers (included in the paper submission)
Addendum C: Formal letters of collaboration (uploaded as PDF file)
Addendum D: Institutional letter indirect costs/overhead (uploaded as PDF file)
Addendum E: Clearance from ethical committee (uploaded as PDF file)
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