Stage 1 New Program Development Application

NEW PROGRAM DEVELOPMENT
STAGE 1 APPLICATION
Section 1: Cover Page Information
1. Title of proposed project (maximum 100 characters with spaces):
2. Principal Investigator information
a) Name:
b) Title:
c) Institution:
d) Address:
e) Phone Number:
f) Email:
3. Office responsible for contracts and grants at sponsoring institution
a) Contact Name:
b) Title:
c) Institution:
d) Address:
e) Phone Number:
f) Email:
4. Dates of proposed project (maximum time period is one year)
a) Project Start Date (mm/dd/yyyy):
b) Project End Date (mm/dd/yyyy):
5. Total amount of request from BEF to the Brady Education Foundation (Note: BEF allows only 10% maximum for indirect costs)
(round off to nearest dollar):
$
6. What is the total projected cost for the project being proposed in this application; include funds requested of BEF and
any current or potential (pending or plans to submit) funding from other sources:
New Program Development - Stage 1 Application
1
7. Other support for this project; current, pending, or plans to submit for other funding to support the project being
proposed in this application
a) Current other support for this project
i) Is other support currently secured for this project? Yes
No
ii) If yes, for each source, provide the following information:
Organization
Start Date of
End Date of
Total Amount
Support
Support
of Support
(maximum 100 characters with spaces)
(mm/dd/yyyy)
(mm/dd/yyyy)
(round off to
nearest dollar)
1.
$
2.
$
3.
$
4.
$
b) Pending other support for this project
i) Are there pending funding requests for this project? Yes
ii) If yes, for each source, provide the following information:
Organization
Date
Start Date
Request
Requested
(maximum 100 characters with spaces)
Submitted (mm/dd/yyyy)
No
End Date
Requested
(mm/dd/yyyy)
(mm/dd/yyyy)
Total
Amount of
Support
Requested
(round off to
nearest $)
1.
$
2.
$
3.
$
4.
$
c) Plans to submit requests for other support for this project
i) Are there plans to submit for other support for this project? Yes
No
ii) If yes, for each source, provide the following information:
Organization
Expected
Start Date
End Date
Submission
To
Be
To Be
(maximum 100 characters with spaces)
Date
Requested Requested
(mm/dd/yyyy)
(mm/dd/yyyy)
(mm/dd/yyyy)
Total
Amount of
Support To
Be
Requested
Expected
Notification
Date
(mm/dd/yyyy)
Expected
Notification
Date
(mm/dd/yyyy)
(round off to
nearest $)
1.
$
2.
$
3.
$
New Program Development - Stage 1 Application
2
Section 2: Aims, Mission, Dissemination, and Collaboration
1. Title of proposed project:
2. Specific Aims/Scope of Work:
a) In one or two sentences, state the Specific Aims of this Project. What are the goals of the specific project being
proposed in this application? (maximum 600 characters with spaces, about 100 words)
b) If other funding partners exist (current or potential), specifically state the scope of the work that BEF funding
would support and specifically state the scope of work to be supported by each other funding source. (maximum
1500 characters with spaces, about 250 words)
3. Mission: The mission of the Brady Education Foundation is to fund projects that seek to close the
achievement/opportunity gap for children living in under-resourced communities (poverty) and/or from
underrepresented populations. Provide a brief explanation of how this project matches this mission. (maximum 600 characters
with spaces, about 100 words)
4. Dissemination: Briefly describe how the findings from this project will be disseminated to:
a) the research community (e.g., peer-reviewed journals, conference presentations, etc.) (maximum 600 characters with
spaces, about 100 words)
b) the practice community (e.g., conference presentations, submissions to listings such as the What Works
Clearing House at the US Department of Education’s Institute of Education Sciences, etc.) (maximum 600 characters with
spaces, about 100 words)
5. Collaboration: Briefly describe how researchers and practitioners and, if appropriate, community stakeholders, will
collaborate to develop this program. (maximum 1,500 characters with spaces, about 250 words)
6. If you are currently working with a potential funder of this program, public (e.g., public school system) or private (e.g.,
foundation), please identify and describe the nature of your relationship with the organization (if working with multiple
potential funders, identify and describe the nature or your relationship with each organization). (maximum 1,500 characters with
spaces, about 250 words)
New Program Development - Stage 1 Application
3
Section 3: Program
1. Title of proposed project:
2. Provide a brief review of the literature that supports the need for this project. (maximum 9,000 characters with spaces, about 1,500
words)
a) References for literature review. (maximum 3,000 characters with spaces, about 500 words)
3. Provide the rationale for the development of this new program. Be sure to address how this new program would differ
from existing programs and improve current practice. (maximum 600 characters with spaces, about 100 words)
4. Describe each of the following for the new program to be developed:
a) Targeted ages to be served by the program: (maximum 150 characters with spaces, about 25 words)
b) Targeted demographic characteristics of population to be served: Complete the following table to provide the
targeted demographic characteristics (race, ethnicity, income and gender) of the intended population to be
served by the new program:
Demographic Characteristics of Target Population
Category
Percent of Program Participants
Racial Category
American Indian / Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
More Than One Race
Unknown
Total
100%
Ethnic Category
Hispanic or Latino
Non Hispanic or Latino
Unknown
Total
100%
Sex / Gender Category
Females
New Program Development - Stage 1 Application
4
Males
Total
100%
Income Category*
Low-Income
Not Low-Income
Total
100%
*Define low-income (e.g., free or reduced price lunch, percent of federal poverty line, etc.):
c) Targeted duration/intensity of program participation (e.g., the program will consist of 60 minute classes that
will take place once a week, for a total of 3 months): (maximum 150 characters with spaces, about 25 words)
d) Targeted program locations (e.g., child care center, school, home): (maximum 150 charters with spaces, about 25 words)
e) Types of activities program participants will engage in: (maximum 600 characters with spaces, about 100 words)
f) Targeted outcomes for program participants: (maximum 600 characters with spaces, about 100 words)
5. Describe how you will address the feasibility of the program and challenges that could be impediments to
implementation of the new program from the perspective of practitioners or service providers. (maximum 600 characters with
spaces, about 100 words)
6. Describe how the new program will be accessible from the perspective of potential program participants, considering
both potential barriers and incentives. (maximum 600 characters with spaces, about 100 words)
7. If eventually this program is found to be feasible, accessible and effective, what are your initial thoughts concerning
the long-term sustainability and affordability of this program in the context of low-resourced families and community
settings (e.g., schools, rural communities, urban communities, etc.)? (maximum 600 characters with spaces, about 100 words)
8. Design and Data Collection:
a) Briefly describe the research design of the proposed project. (maximum 3,000 characters with spaces, about 500 words)
b) Provide the total intended sample size (N) for this project. (maximum 100 characters with spaces, about 17 words)
c) If subgroups will be used as part of the design, identify and provide the sample sizes for each subgroup.
(maximum 100 characters with spaces, about 17 words)
d) Describe how the sample will be recruited (and maintained over time, if applicable). (maximum 100 characters with
spaces, about 17 words)
New Program Development - Stage 1 Application
5
e) Complete the following table to provide the intended demographic characteristics (race, ethnicity, income and
gender) of the expected participants in this study.
Demographic Characteristics of Study Sample
Category
Number of Participants (n)
Percent of Participants (%)
Racial Category
American Indian / Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
More Than One Race
Unknown
Total (N)
100%
Ethnic Category
Hispanic or Latino
Non Hispanic or Latino
Unknown
Total (N)
100%
Sex / Gender Category
Females
Males
Total (N)
100%
Income Category*
Low-Income
Not Low-Income
Total (N)
100%
*Define low-income (e.g., free or reduced price lunch, percent of federal poverty line, etc.):
New Program Development - Stage 1 Application
6
f) Briefly describe the procedures that will be used to develop the program, to collect data, and to conduct other
proposed activities, as applicable. (maximum 3,000 characters with spaces, about 500 words)
g) Briefly describe the data to be collected, including: (maximum 3,000 characters with spaces, about 500 words)
i) any data that might be collected that will inform feasibility, accessibility and affordability of the
program
ii) any data that might be collected to assess participant outcomes
III) any other data that might be collected and reasons for collecting these data
h) Briefly describe what types of analyses will be conducted. (maximum 3,000 characters with spaces, about 500 words)
9. Environments:
a) Briefly describe the setting in which the program development will take place (e.g., if developing the program
in a school setting, describe that school setting). (maximum 1,500 characters with spaces, about 250 words)
b) Briefly describe the research environment of the PI (and other key research personnel if at different
institutions), particularly noting facilities, equipment and other services that will support the proposed project
(e.g., university sponsored computer support, statistical consulting, etc.). (maximum 3,000 characters with spaces, about
500 words)
10. Note that the Foundation favors projects that include a member of the team (not necessarily the PI) who has
experience leading projects of similar or greater scope. Please describe the PI and other team members' prior research or
other professional experience that demonstrate the team's qualifications to do this project. In this reply, please describe
any prior experiences the PI or others on the research team may have had with the specific methods being proposed
(including any pilot work related to this project, if applicable) (1,500 characters with spaces, about 250 words)
11. Other: Other than budgetary information to be provided below, if applicable, provide any additional information you
want the Board to consider when evaluating this Stage 1 application (2,400 characters with spaces, about 400 words)
New Program Development - Stage 1 Application
7
Section 4: Budget
Complete the following table for the project, specific to the scope of work that would be supported by BEF funding (do not include current or potential
funding from other sources).
1.
Note that indirect costs or overhead costs may not exceed 10% of total project costs. Be sure that indirect costs for any subcontract institutions are
only 10%. Primary institution may not charge additional indirect on the subcontract funds.
2.
The Foundation follows National Institutes of Health guidelines for salary cap (current cap is $185,100).
3.
The Foundation will support up to two key personnel from the project team and one practitioner or service providers from the program to attend
one conference, with an allowable cost of $1,500 per person.
4.
For each subcontractor, complete the subcontractor budget form (included after the project budget table).
PROJECT BUDGET (round off to nearest dollar or percent)
PERSONNEL, e.g., PI, Co-PI, GRA, Data Collector, Data Entry, Database Development, Teacher, Mentor, etc.
Name
Title
FTE% Institutional Requested
Salary
Salary
%
%
%
%
%
%
$
$
$
$
$
$
$
$
$
$
$
$
Fringe
Benefits
$
$
$
$
$
$
TOTAL PERSONNEL
Total
Requested
$
$
$
$
$
$
$
SUPPLIES, e.g., printing, copying, office supplies, curriculum, books, software, etc. (max. 80 characters with spaces)
$
$
$
TOTAL SUPPLIES
$
EQUIPMENT, e.g., cameras, computer, recording devices, etc. (max. 80 characters with spaces)
$
$
TOTAL EQUIPMENT
$
TRAVEL, e.g., mileage, travel to conferences, participant travel, etc. (max. 80 characters with spaces)
$
$
TOTAL TRAVEL
$
OTHER, e.g., participant stipends, food for focus groups, childcare (max. 80 characters with spaces)
$
$
TOTAL OTHER
$
TOTAL DIRECT
$
INDIRECT (10%)
$
SUBCONTRACTS (provide separate budgets for each) (max. 80 characters with spaces)
$
TOTAL SUBCONTRACTS
TOTAL PROJECT COST
$
$
New Program Development - Stage 1 Application
8
SUBCONTRACTOR BUDGET (round off to nearest dollar or percent)
Subcontractor Company Name:
PERSONNEL, e.g., PI, Co-PI, GRA, Data Collector, Data Entry, Database Development, Teacher, Mentor, etc.
Name
Title
FTE% Institutional Requested
Salary
Salary
%
%
%
%
%
%
%
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Fringe
Benefits
$
$
$
$
$
$
$
TOTAL PERSONNEL
Total
Requested
$
$
$
$
$
$
$
$
SUPPLIES, e.g., printing, copying, office supplies, curriculum, books, software, etc. (max. 80 characters with spaces)
$
$
$
$
TOTAL SUPPLIES
$
EQUIPMENT, e.g., cameras, computer, recording devices, etc. (max. 80 characters with spaces)
$
$
$
TOTAL EQUIPMENT
$
TRAVEL (max. 80 characters with spaces)
$
$
TOTAL TRAVEL
$
OTHER (max. 80 characters with spaces)
$
$
TOTAL SUBCONTRACATOR COST
New Program Development - Stage 1 Application
TOTAL OTHER
$
TOTAL DIRECT
$
INDIRECT (10%)
$
$
9