Application Number: 1 of 12 Principal Applicant:

PROPOSAL Rapid Response 2015

DEADLINE: Tuesday, September 15th, 2015, 2:00 p.m. EDT

Award announcements will be made in October 2015.

This Proposal is an example only. Do not complete this paper application. Please submit the Proposal online through the Institute’s grant management system at

https://weston.smartsimple.ca/welcome/neuroscience Application Number:

Principal Applicant:

Project Title:

Applicant Details

Team Members Organizations Primary Contact Information

Role in Project Estimated Time Spent on Project

1. Salutation: First Name: Last Name:

Primary Organization: Position Title: Other Affiliations/ Position Titles:

Address: Phone: Email:

Principal Applicant Administrative Supervisor Co-Applicant Collaborator

%

2. Salutation: First Name: Last Name:

Primary Organization: Position Title: Other Affiliations/ Position Titles:

Address: Phone: Email:

Principal Applicant Administrative Supervisor Co-Applicant Collaborator

%

Note: Projects are not limited to two team members as laid out on this sample application form; projects may include as many team members as needed for the successful execution of the project. A curriculum vitae (NIH biosketch or equivalent) of five pages or less is required for each team member.

https://weston.smartsimple.ca/welcome/neuroscience

Application Number: 2 of 12 Principal Applicant:

Application Overview Keywords to describe the proposed work:

What type of tool(s) and/or therapeutic(s) is being developed as the main goal of the project? (Please select only the tool(s) and/or therapeutic(s) that are being developed as a main goal of the project; do not select items that are being used as part of the project, e.g., do not select “Animal Model” unless you are developing a new animal model. There is no benefit to selecting more items than fewer items.)

Tool Animal model Assay/screen Biomarker Cell line Clinical assessment instruments Diagnostic Imaging technique or reagent New method of drug delivery Probe Other Please specify:

Therapeutic Biologic Cell therapy Electrical brain stimulation Magnetic brain stimulation Medical device Small molecule Surgical intervention Vaccine Other Please specify:

If a therapeutic is being developed, what phase(s) of development does the project cover? (please select all that apply)

Target validation Assay development Screening and hits to leads Lead optimization

Safety and toxicity in animals Efficacy in animals Phase I Clinical Trial Phase II Clinical Trial Other Please specify:

Research will have a significant impact in which neurodegenerative disease(s) of aging? (Please select all that apply. There is no benefit to selecting more diseases than fewer diseases.)

Alzheimer’s disease Amyotrophic lateral sclerosis Dementia with Lewy Bodies Frontotemporal dementia

Multiple system atrophy Parkinson’s disease Progressive supranuclear palsy Mild cognitive impairment as prodromal to one of the other listed diseases

Have you applied to other funding agencies with the same proposed work? (This information will not be used to assess the application)

Yes Please specify: No

Application Number: 3 of 12 Principal Applicant:

Is this your first time applying for a neuroscience grant from the Weston Brain Institute? (This information will not be used to assess the application)

Yes No

Is this your first application for a research grant specifically in the area of neurodegenerative diseases of aging? (This information will not be used to assess the application)

Yes No

Other funding support: What percent of the proposed work is being funded by other grants?

Location of work: what proportion of proposed work is being carried out outside of Canada? If any, please explain how this will bring unique resources into Canadian-led work.

Application Number: 4 of 12 Principal Applicant:

Project Information 1. Background Please critically evaluate existing knowledge and identify the gaps that this project is intended to fill. Please mention any preliminary data and include as attachment in supplementary materials (maximum 400 words)

2. Goals and specific aims: (maximum 300 words)

3. Experimental approach: How are you going to carry out the proposed work? Please include: detailed experimental design and methods, and alternative approaches at critical milestones if needed. (maximum 2000 words)

4. Limitations of proposal: What do you consider to be the limitations of this Proposal overall, not only to the Experimental Approach? (maximum 300 words)

5. Innovation: What is innovative about the proposed work? Is the creation, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation or interventions proposed? (maximum 300 words)

6. Significance and Impact: How will successful completion of this work accelerate the development of therapeutics for neurodegenerative diseases of aging? Why is it important that the proposed work be carried out? (maximum 300 words)

Application Number: 5 of 12 Principal Applicant:

7. Development Plan: What is your general administrative and experimental plan for advancing this line of inquiry to the point of relevance to sufferers of neurodegenerative diseases of aging? (maximum 300 words)

8. Team and environment: Why are the investigator(s), environment and collaborations (if applicable) particularly suited to achieve the aims of the proposed work? (maximum 200 words)

List of publications cited in the application and other publications directly relevant to the proposed work: Please include full citations and PMID.

Application Number: 6 of 12 Principal Applicant:

Budget

Personnel Costs

Name Role in Project

Estimated Time Spent on Project

Base Salary Salary Requested

Benefits Requested

Total

1. %

2. %

Subtotal $

Laboratory Supplies

Description Unit Cost Number of Units

Total

1.

2.

Subtotal $

Animal Costs

Description Unit Cost Number of Units

Total

1.

2.

Subtotal $

Patient Care Costs

Description Unit Cost Number of Units

Total

1.

2.

Subtotal $

Other Costs

Description Unit Cost Number of Units

Total

1.

2.

Subtotal $

Total Requested Budget $

Budget Justification: How do the budget items appropriately support the work proposed?

Application Number: 7 of 12 Principal Applicant:

MILESTONE INSTRUCTIONS Rapid Response 2015

Instructions Please list key milestones for your project. Milestones will be used to help follow the progress of the proposed project. Funds will be disbursed in tranches, linked to the completion of these milestones. Funds should be disbursed in approximately 2 tranches per year (e.g., a total of 3 tranches for a 1.5 year grant); however, alternatives can be proposed (please describe why under Notes). Information Required Descriptions/Explanations

Start-Up Funding

Amount requested

Payment Date

If justified, a small amount of funding may be released to support initial milestones that must occur before work starts, such as hiring staff or obtaining research ethics board approvals. Milestones in this category must be completed before payment for the 1st tranche of funding can be released and the project can begin. Date requested to receive payment relating to Start-Up Funding milestones. Format: e.g., 17 February 2015

Project Start and End date Format: e.g., 17 April 2015 Excludes Start-Up Funding

Tranches

Amount requested for each tranche

Start and End Date for each tranche

Indicate the amount of grant funds required to complete listed milestones within each tranche. Funding requested between tranches should match the budget requested. The Start Date is the date by which funding is expected to be released. Previous milestones (including Start-Up Funding milestones, if any) must be completed before the next tranche payment is released. Format: e.g., 17 April 2015

Milestones

List milestones that will be completed within each tranche

Indicate relevant aims for each milestone within each tranche under Project Aim

Provide quantifiable milestones in each

Milestones should be tailored to the project and work proposed, and designed so that whether or not they have been met can be clearly determined.

See milestone template example on page 2.

Examples: Recruitment of 20 patients; generation of animal

Application Number: 8 of 12 Principal Applicant:

tranche

If work is ongoing or covers multiple tranches (e.g., recruiting patients), please provide interim milestones for each tranche. Include running totals.

colony of 50 mice; perform power analysis; hire 1 post-doctoral student to perform mouse behavioural testing Example: Recruiting 30 patients across 1 year for CSF collection can be divided into milestones as follows: 1st tranche – CSF collected from 20 patients (running total: 20/30) 2nd tranche – CSF collected from 10 patients (running total: 30/30)

Example: Start-Up Funding (optional)

Amount: $5,000

Payment Date: 01 June 2015

Description

1. Research ethics board approvals

1st Tranche of Funding Amount:

$50,000 Start Date: 01 October 2015

End Date: 31 March 2016

Project Aim

List of milestones to be completed with the 1st Tranche of funding

1 Generation of 3xTg AD mice, N=50 (running total=50/100)

1 Generation of Control mice, N=50 (running total=50/100)

2 Complete setup of behavioural suite for object recognition test

2nd Tranche of Funding Amount:

$50,000 Start Date: 01 April 2016

End Date: 31 October 2016

Project Aim

List of milestones to be completed with the 2nd Tranche of funding

1 Generation of an additional 3xTg AD mice, N=50 (running total=100/100)

1 Generation of an additional Control mice, N=50 (running total=100/100)

2 Perform object recognition test on 3xTg AD mice, N=25 (running total=25/100)

2 Perform object recognition test on 3xTg AD mice, N=25 (running total=25/100)

3 Measure tau phosphorylation levels from 3xTg AD mice brain soluble fractions following behavioural testing, N=25 (running total=25/100)

3 Measure tau phosphorylation levels from Control mice brain soluble fractions following behavioural testing, N=25 (running total=25/100)

Application Number: 9 of 12 Principal Applicant:

MILESTONES Rapid Response 2015

Application Number:

Principal Applicant:

Project Title:

Start-Up Funding (optional)

Amount: $

Payment Date:

Description

1.

2.

3.

Project Start Date: Month, Date, Year

Project End Date: Month, Date, Year

1

st Tranche of Funding Amount:

$ Start Date:

End Date:

Project Aim List of milestones to be completed with the 1st

Tranche of Funding

2

nd Tranche of Funding Amount:

$ Start Date:

End Date:

Project Aim List of milestones to be completed with the 2nd

Tranche of Funding

3

rd Tranche of Funding Amount:

$ Start Date:

End Date:

Project Aim List of milestones to be completed with the 3rd

Tranche of Funding

(Include additional tranches of funding if needed, i.e., 4th Tranche of Funding, etc.)

Notes (if needed):

Application Number: 10 of 12 Principal Applicant:

Supplementary Materials (optional) You may submit supplementary materials to a maximum of 20 pages. The content included under Supplementary materials should be directly relevant to the proposed work or cited in the Proposal. Any materials beyond 20 pages, and/or that are not relevant will not be reviewed. Supplementary materials should not contain additional text for the application. Please note that this component of the proposal application is optional so it is not meant to be onerous. Supplementary materials may include:

Photographs, figures, tables

Preliminary data

Up to 1 manuscript relevant to the project

Any patents (pending or granted) related to the project

Application Number: 11 of 12 Principal Applicant:

Principal Applicant/Institutional Signatures Please ensure the necessary parties sign this page. “Per” signatures cannot be accepted. This Proposal may be executed by the parties in counterparts and may be delivered in electronic format, with all counterparts and electronic transmissions being as effective as a manually executed copy and together will constitute one and the same Proposal. I declare that to the best of my knowledge the statements and other information contained in this application are truthful, complete, and accurate. I further understand that an incomplete application will not be reviewed. Principal Applicant: Signature Print Name Date Official Institutional Signature of Principal Applicant’s Institution: Signature Print Name Date Administrative Supervisor (needed only if Principal Applicant is a Postdoctoral Fellow) Signature Print Name Date

Application Number: 12 of 12 Principal Applicant:

Co-Applicant/Collaborator Signatures Please have all co-applicants and collaborators sign this page. “Per” signatures cannot be accepted. This Proposal may be executed by the parties in counterparts and may be delivered in electronic format, with all counterparts and electronic transmissions being as effective as a manually executed copy and together will constitute one and the same Proposal. Please note that while we need to have the signatures of all the co-applicants named in this proposal, it is not necessary to have all the signatures on a single page. Thus, each co-applicant may sign his/her own copy of this page. I am aware that I am a collaborator on this grant and I declare that to the best of my knowledge the information contained in this application are truthful, complete, and accurate. Co-Applicant/Collaborator: Signature Print Name Date Co-Applicant/Collaborator: Signature Print Name Date Co-Applicant/Collaborator: Signature Print Name Date Co-Applicant/Collaborator: Signature Print Name Date Co-Applicant/Collaborator: Signature Print Name Date