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Application form

RESEARCH IMPACT FUND – APPLICATION FORM

 

Proposal Reference No.

(Not to be filled by the applicant)

 

 

Title of Project:

 

Duration of Project:

 

Total Budget Requested

PKR

Theme of Proposed Research

Basic Sciences

Applied Sciences

Area of Proposed Research

 

 

Principal Investigator

Name

Position/Title

Department

Tel. # (Office/Mobile/Res)

Email

CNIC No.

 

Academic Collaborator/s (If any)

Name of Collaborator

Institution of Collaborator

Country

Location

Focus of collaboration:  education or research

Tel. #

Email

 

Sectoral Collaborators from Pakistan (If any)

Company/Organization Name

Location

Country

Name of Collaborator

Position/Title

Tel. #

Email

Anticipated Contribution to Project Goals

Anticipated Annual Financial Contribution

 

Briefly describe the socioeconomic impact of your research project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Briefly describe the budgeting plan of your project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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. 

 

 

 

 

 

Identify the most significant (between three and five) limitations/weaknesses in your project that exist at the launch of the proposed project. 

 

 

 

 

 

 

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.

 

 

 

 

 

 

 

 

 

 

Kindly provide details of any research grant received within past 5 years.

Sr.

Title of Project

 

Initiation date

Completion date

Amount(s) awarded

Funding source(s)

 

 

 

 

 

 

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

 

  1. Completed & signed Research Impact Fund application form
  2. Research Proposal (according to L-ORIC template available at ORIC section of CMH LMC & IOD website).
  3. Ethical Certificate duly signed by Ethical Review Committee of CMH LMC & IOD
  4. Declaration certificate

 

Declaration Certificate for RIF

 

The undersigned, Dr. _________________________ hereby declare that as a Principal Investigator (PI) of the project titled “_____________________________________________________________________________________________________________________________________________”

 

  1. I have read and agreed to the Research Impact Fund (RIF) policy available at ORIC section of CMH LMC & IOD website.
  2. I am a fulltime faculty member of CMH LMC & IOD.
  3. The equipment(s) I have demanded for the proposed project is / are not available in the Institute.
  4. 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.
  5. Proportion of research project funded by HEC or any other funding agency is disclosed in the application above.
  6. The proposed project is genuinely novel and that there is no plagiarized material including self-plagiarism.
  7. I have never been blacklisted by CMH LMC & IOD or Higher Education Commission (HEC) Pakistan.
  8. I am not executing any other funded project as PI or Co-PI of this institution or HEC which is delayed.
  9. 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.
  10.  All publications from this project will bear affiliation of author with CMH LMC & IOD.
  11. 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.
  12. 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.

 

 

Signature of Principal Investigator

Name:

Designation:

Department:

Institution:

 

 Signature of Collaborator (If any)

Name:

Designation:

Department:

Institution:

 

 

 

 

Signature with Stamp of the Chairperson Research Impact Fund Committee

 

Name:

Department Name:

Institution: