Annual Grant Apply Now! Name * First Name Last Name Email * Phone * Current Position/Appointment * Department * What are you applying for? * Equipment Patient Care Program Facilities Salary Support Research (including salary support for research projects) Other (please specify) Please specify * Has this application been discussed with the Mater hospital General Manager or Director of Clinical Services for inclusion in the capital expenditure budget? * Yes No What is the grant amount requested? * $ Please provide a description of what you are applying for * What is the likely impact to patient care? What is the expected benefit to your department and staff? How does this application fit within the priorities of the department? Have you submitted an application, or do you intent to apply to other bodies for funding? Yes No If yes, please name the funding body Other members of your research team (if applicable) Please include their: - Title - First & Last Name - Email Address - Phone Number - Current Position/Appointment - Department All applications for research will require Human Ethics Committee Approval Prior to Grant Payment. Have you submitted this research proposal to St Vincent’s Human Ethics Committee? Yes No Do you have site authorisation? Yes No What is the grant amount requested? $ Briefly describe the research proposal, including the likely impact to patient care and the significance for the Mater Please supply detailed budget for grant (please select all that apply) Equipment Consumables Salaries Other Have you submitted an application, or do you intent to apply to other bodies for funding? Yes No If yes, please name the funding body How does this item fit within the priorities of the department? Details of previous and current grants funded by the Foundation Thank you!
