
Application form
RESEARCH IMPACT FUND – APPLICATION FORM
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 |
Area of Proposed Research |
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Principal Investigator |
Name |
Position/Title |
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Department |
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Tel. # (Office/Mobile/Res) |
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CNIC No. |
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 |
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 |
Tel. # |
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Anticipated Contribution to Project Goals |
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Anticipated Annual Financial Contribution |
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
YEAR ONE |
Major Tasks and Deliverables |
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YEAR TWO |
Major Tasks and Deliverables |
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YEAR THREE |
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: It is hereby certified that:
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Signature of Principal Investigator Name: Designation: Department: University/ DAI Name
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Signature of Collaborator (If any) Name: Designation: Department: University/ DAI Name
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Signature with Stamp of the Head of Department
Name: Department Name:
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