1.   Principal Applicant’s Contact Details

2.   Project Summary

Abstract (500 words maximum)
Media Summary of Research or Project (200 words maximum)
Explain the research project, and its significance to health, in language understandable to the public as a press release.
Outcome Statement
Explain what utility or benefits the research may have (e.g. leading to a treatment, diagnosis, product or service, not papers and abstracts etc - these are outputs).

3.   Funding Sought

Total cost of project:

Other sources of funding:

Amount applied for:

Please note: the Foundation is not registered for GST.

4.   First Co-applicants’ details (if applicable)

5.   Second Co-applicants’ details (if applicable)

SECTION A: PROPOSED INVESTIGATION

Nature and Purpose of Project

Provide sufficient detail for the Foundation’s Grants Committee to understand the nature and purpose of the investigation.

Background and Significance of the Project

Provide a brief review of relevant published or completed research to show the significance of the project (and how it relates to previous or ongoing work by the investigators), if applicable. Minimise the use of abbreviations and provide an abbreviation key if abbreviations are used. As appropriate, include relevance or impact of current issue for Māori.

Specific Aims of the Project

State the principal research questions/hypotheses and aims/objectives.

Research Design and Methods

Describe the main methods to be used to achieve the aims of the project. Include information on goals and strategies for participation of Māori in this project. Outline specific measures that will be undertaken to strengthen health advancement for Māori participants or Māori communities.

Statistical Analysis Plan

Describe the analysis plan for the project in sufficient detail that the Grants Committee can assess the appropriateness of the intended analyses and statistical methods. Sample size calculations should be included where relevant to demonstrate the adequacy of subject numbers.

Research Impact

Describe the potential impact of the project on health outcomes, healthcare delivery and workforce development. Outline specific benefits to the Waikato region. Include information on potential advancement of Māori health, or improvements in equity that are expected from the project

Proposed Publication or Dissemination of Project's Results

Describe how you plan to disseminate the results.

Proposed Timetable

State the estimated start and completion dates of the project and its components.

References

SECTION B: SUPPORT FOR THE PROJECT

Institutional support available (provide details under the following headings)

(a)    Location

(b)    Funding from other sources

(c)    Availability of necessary support services

Note: Applicants should ensure that they have the support of their institution and that the necessary space, facilities, insurance cover, maintenance, services and technical assistance are available. Confirmation of this by the Head of Department in the relevant Institution guaranteeing these requirements is required, either in Section E or as a separate letter attached to the application.

Ethical Approval

All successful applications involving human and animal subjects must seek Ethical Approval. This approval is not required on application, but is required to complete grant funding requirements. Ethics Approval must be obtained within six months of the grant being awarded, after which time the grant may be withdrawn.

A copy of this approval should be forwarded to the administrator to complete the Grant requirements prior to funds being released. For human subjects, online HEDC applications are made at http://ethics.health.govt.nz

SECTION C: DETAILED BUDGET

Provide a detailed budget with full supporting documentation, calculations and the period of expenditure. Grant support is usually limited to 12 months, but a longer period (up to 2 years maximum) may be granted at the discretion of the Trustees if clearly justified below.

Suggested headings are given below, but some categories may not be relevant to your project. Lack of justification will result in a reduced overall score.

If you are only applying for part-funding from WMRF, clearly identify what is being paid by other sources.

*Attach quotations for cost of equipment.

Note:
The Foundation does not support major capital items, including equipment, exceeding $5,000.

Budget Justification

SECTION D: RESEARCH BACKGROUNDS & CURRICULUM VITAE OF PRINCIPAL APPLICANT AND PARTICIPATING STAFF

Please use the New Zealand MSI standard Curriculum Vitae Template. All of Part 1 and Part 2a should be completed. The total CV should not exceed 5 pages (2 pages for Part 1 and 3 pages for Part 2a).

Please click here to download the template. Once completed, please upload it using the following button.

Upload the completed C.V. here:

SECTION E: CERTIFICATION

Certification that the Director/Head of Department or relevant controlling officer, has agreed that the work may be undertaken in the applicant's institution.

Please click here to download the certification template. Once completed, please upload it using the following button.

Upload the completed certification here: