Research Grant Application Form

Overview

This form is for applicants seeking an Investigator-Initiated Study Research Grant. These grants provide financial support or products for studies that are independently initiated, developed, and managed by a qualified investigator who takes full responsibility for conducting the study.

Submission Guidelines

Applications must be submitted at least 90 days before the intended study start date to allow for proper review.

Application Reference Number

After submitting your application, you will receive a unique reference number via email. Please keep this number handy and include it in all future correspondence regarding your application.

Required Documentation Submission

Within one week of submitting your application, you’ll receive an email with instructions for submitting the required documentation listed below. You will then have ten days to provide these documents to complete your NHRDI grant application. To avoid delays or potential denial, please gather all necessary documents before applying and ensure they are complete.

Required Documentation

Primary investigator information

Date

Name of Contact / Primary Investigator

Organization

Title

Address

City

State / Province

ZIP / Postal Code

Country

Phone Number

Email Address

Website

To your knowledge, do any actual or potential conflicts of interest exist between the applicant and/or the requesting organization and NHRDI (e.g., are any applicants related to a NHRDI employee)?

Yes

Within the past 5 years, has the primary investigator been the subject of any government investigation or proceeding involving fraud or corruption (e.g., bribery, money laundering, or other corrupt practices)?

Yes

Parent Organization

Is the requesting primary investigator affiliated with a larger organization?

Yes

Prior Funding

Have you ever received funding from NHRDI before?

Yes

Study Proposal

General Information

Study title

Area(s) to be studied

Support requested

Funding

Technical assistance only

Funding and technical assistance

Research Statement

Provide a brief summary of your proposal, including the overall goal, target population, method, etc.

Requested Support and Funding

Total Study Costs

$USD

Amount Requested

$USD

Other support requested

Please share additional sources of funding, if any (Grants, supporters, etc.)

Project Lead - Principal Investigator (PI)

PI Full Name

Email Address

PI Current Title / Position

Country of Residence

Address

City

State / Province

ZIP / Postal Code

Is the PI a US-licensed clinician?

Yes

CO-Investigator (CI)

Is there a Co-Investigator (CI)?

Yes

Research Site Information

Name / Type of Site

City

State / Province

ZIP / Postal Code

Primary Site Contact

Email Address

Phone Number

Multi-Site Study?

Yes

Proposal Details

Research Design / Methodology

Research Question or Hypothesis

Sample Size

Population

Proposed Length of Study (in months)

Has the study received IRB approval?

Yes

Describe the rationale/relevance to advancing the human species.

Briefly describe your proposed procedures.

Cite 3-5 relevant references (Articles, related studies, etc.)

Future Plans

Do you hope to publish the results of the study?

Yes

Do you hope to provide a public presentation of the results of the study?

Yes

Would you consent to your results being published on the NHRDI website?

Yes

Payment

Is the Payee address the same as the organization address?

Yes

In the subject line, please include: "Research Grant Applicant" followed by the name of the Primary Investigator.

Research Grant Application Form

Overview

Submission Guidelines

Application Reference Number

Required Documentation Submission

Required Documentation

Required Documentation

Primary investigator information