Application form
RESEARCH IMPACT FUND – APPLICATION FORM
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Proposal Reference No. (Not to be filled by the applicant) |
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Title of Project: |
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Duration of Project: |
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Total Budget Requested |
PKR |
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Theme of Proposed Research |
Basic Sciences |
Applied Sciences |
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Area of Proposed Research |
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Principal Investigator |
Name |
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Position/Title |
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Department |
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Tel. # (Office/Mobile/Res) |
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CNIC No. |
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Academic Collaborator/s (If any) |
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Name of Collaborator |
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Institution of Collaborator |
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Country |
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Location |
Focus of collaboration: education or research |
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Tel. # |
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Sectoral Collaborators from Pakistan (If any) |
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Company/Organization Name |
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Location |
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Country |
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Name of Collaborator |
Position/Title |
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Tel. # |
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Anticipated Contribution to Project Goals |
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Anticipated Annual Financial Contribution |
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Briefly describe the socioeconomic impact of your research project. |
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Briefly describe the budgeting plan of your project. |
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Describe the physical resources and facilities that are already available to the proposed project. Be sure to comment on how these resources and facilities will enable the workplan of the proposed project to be accomplished. |
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Identify the most significant (between three and five) limitations/weaknesses in your project that exist at the launch of the proposed project. |
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Describe the potential risks that could imperil the progress and success of the proposed project, and describe the strategy and process that will be used to minimize and address these risks. |
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Kindly provide details of any research grant received within past 5 years. |
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Sr. |
Title of Project
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Initiation date |
Completion date |
Amount(s) awarded |
Funding source(s) |
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RESEARCH PROJECT IMPLEMENTATION TIMELINE
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YEAR ONE |
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Major Tasks and Deliverables |
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YEAR TWO |
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Major Tasks and Deliverables |
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YEAR THREE |
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Major Tasks and Deliverables |
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EXECUTIVE SUMMARY
The Executive Summary (limited to one page) provides an overview of the proposed research project. It should clearly identify the research questions/ challenges related to priority areas of national relevance and justify how the proposed project addresses those challenges for socio-economic development of the country.
REQUIRED ATTACHMENTS
- Completed & signed Research Impact Fund application form
- Research Proposal (according to L-ORIC template available at ORIC section of CMH LMC & IOD website).
- Ethical Certificate duly signed by Ethical Review Committee of CMH LMC & IOD
- Declaration certificate
Declaration Certificate for RIF
The undersigned, Dr. _________________________ hereby declare that as a Principal Investigator (PI) of the project titled “_____________________________________________________________________________________________________________________________________________”
- I have read and agreed to the Research Impact Fund (RIF) policy available at ORIC section of CMH LMC & IOD website.
- I am a fulltime faculty member of CMH LMC & IOD.
- The equipment(s) I have demanded for the proposed project is / are not available in the Institute.
- I ensure that the adjustments (receipts) against the funds released in the installments will be submitted before next installment, In case I am not able to do so, I will return all the funds released to me till then within 3 days of ‘letter issued for submission of adjustments for RIF’ by the Chairperson RIF committee.
- Proportion of research project funded by HEC or any other funding agency is disclosed in the application above.
- The proposed project is genuinely novel and that there is no plagiarized material including self-plagiarism.
- I have never been blacklisted by CMH LMC & IOD or Higher Education Commission (HEC) Pakistan.
- I am not executing any other funded project as PI or Co-PI of this institution or HEC which is delayed.
- In case I leave this institution or am relieved from my services by the institution’s higher authorities before completion of this project; I will return the amount sanctioned to me from RIF till that time, before my departure.
- All publications from this project will bear affiliation of author with CMH LMC & IOD.
- In all publications of this project I will acknowledge funding from RIF of CMH Lahore Medical College & IOD, under the Funding Disclosure subheading in the manuscript.
- I agree that the decision of college higher authorities at any stage of funding will be considered final and will not be challenged in a court of law.
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Signature of Principal Investigator Name: Designation: Department: Institution:
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Signature of Collaborator (If any) Name: Designation: Department: Institution:
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Signature with Stamp of the Chairperson Research Impact Fund Committee
Name: Department Name: Institution: |
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