EULAR Health Professionals research grant application
1. Basic data
Project title
Requested start
Requested duration
Requested funding (€)
Project leader
Name, first name
Academic degree
Present academic post
Institution
Work address
Telephone
Email address
The project leader confirms herby that the information given is accurate to the best of his/her knowledge
including the attachments, and accepts the terms mentioned in the guidelines under which the award is
given.
Place, date
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
Signature
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2. Project co-workers personal data (only for research groups)
1. Co-worker
Name, first name
Academic degree
Present academic post
Institution
Work address
Telephone
Email address
2. Co-worker
Name, first name
Academic degree
Present academic post
Institution
Work address
Telephone
Email address
3. Co-worker
Name, first name
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
2
Academic degree
Present academic post
Institution
Work address
Telephone
Email address
4. Co-worker
Name, first name
Academic degree
Present academic post
Institution
Work address
Telephone
Email address
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
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3. Participating units and networking
National networking
Yes
No
Yes
No
If yes, with which
person/groups/institutions?
If yes, in which context?
International networking
If yes, with which
person/groups/institutions?
If yes, in which context?
4. Detailed budget
Your budget should include all costs associated with the project. Please supply all costs in Euro (€).
Salaries
EULAR funds
Third party
Own funds
funds
Project leader
Name, first name
Estimated working hours
Direct salaries
Indirect salaries (including social cost and
hospital/university overhead cost)
1. Co-worker
Name, first name
Estimated working hours
Direct salaries
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
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Indirect salaries (including social cost and
hospital/university overhead cost.)
2. Co-worker
Name, first name
Estimated working hours
Direct salaries
Indirect salaries (including social cost and
hospital/university overhead cost)
3. Co-worker
Name, first name
Estimated working hours
Direct salaries
Indirect salaries (including social cost and
hospital/university overhead cost)
4. Co-worker
Name, first name
Estimated working hours
Direct salaries
Indirect salaries (including social cost and
hospital/university overhead cost)
Total salaries
Equipment
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
EULAR funds
Third party
(€)
funds (€)
Own funds (€)
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Total equipment
Materials and consumables
Total materials and consumables
Meetings (please give details regarding purpose,
location, attendees)
Total meetings
Miscellaneous (please give details)
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
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Total miscellaneous
Total amounts of project funding
Breakdown of the EULAR funds by headings
Total in €
Salaries
Equipment
Materials and consumables
Meetings
Miscellaneous
Total EULAR fund
Project plan
Please supply a detailed project outline, using the following headings:
A. Summary
B. Background and rationale for the study
C. Research objectives
D. Methods
-
Design
-
Participants
-
Assessments
-
Intervention (if applicable)
-
Data analyses
E. Timetable and milestones
F. Involvement of patients as research partners (if applicable)
G. Will ethical approval be required for this research? If yes, please indicate which ethical committee,
planned submission date, timeframe
H. Significance of the planned work
a. Scientific significance
b. Relevance for EULAR Health Professionals
I.
Dissemination of the research results
J.
Implementation plan
Patrizia Jud | Executive Assistant
EULAR Secretariat | Seestrasse 240 | 8802 Kilchberg | Switzerland
T: +41 44 716 30 37 | F: +41 44 716 30 39
[email protected] | www.eular.org
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