MENTORED SCIENTIST AWARD PROGRAM IN HIV/AIDS
INSTRUCTION FORM
Resource Allocation Program (RAP)
University of California San Francisco

Proposal Length: maximum 6 pages, including figures and tables, excluding literature cited.
Format Requirements:  Arial font; 11 pt; minimum 0.5 inch for all margins; no appendices.

Please create one single PDF file including all of the following information:

1. Project Title

2. Amount Requested: $

3a. P.I. Name

. Title
. Department/Affiliation
. Email address
. Box No. (or mailing address)
. Phone

3b. Mentor(s)

. Title
. Department/Affiliation
. Email address
. Box No. (or address)
. Phone

4. Co-Investigator Names

. Titles
. Department/Affiliation
. Email address
. Box No. (or address)
. Phone

5. Grant Administrator

. Title
. Department/Affiliation
. Email address
. Box No. (or address)
. Phone

6. Specify if you have been funded in the past 5 years by one of the following UCSF agencies: List titles of grants in detail. Include enough information to allow RAP to understand their content. Specify dollar amounts awarded and source of funds (e.g., REAC).

. CTSI-SOS
. REAC
. CFAR
. ARI
. Cancer Center-CIRP
. NCOE
. Academic Senate
. Departmental Startup Funds
. Other UCSF (explain _____)

7. Abstract (one paragraph only, max 300 words, summary of project including objective, design, duration of study, and statistical analysis of data).

8. Proposal (maximum 6 pages, including figures and tables, excluding literature cited)

a. Aims (list three aims)
b. Background and Significance
c. Preliminary studies
d. Experimental Design and Methods (include time-table)
i Hypothesis, ii) Rationale, iii) Experimental approach, iv) Interpretation of results
e. Explain how this pilot project is important for your career goals (e.g., lead to major funding, etc.) (max 500 characters)
f. Literature cited (not included in page limit)
g. Human Subjects: describe patients, specimens, and/or human subject data that will be used in your research, and describe the methods that will be used to protect subjects and/or information

9. Budget ($40,000 maximum direct costs per proposal) Use the NIH PHS 398 form "Page 4: Detailed Budget for Initial Budget Period" (http://grants.nih.gov/grants/funding/phs398/fp4.doc) to prepare your budget

Mentored Scientist Award Program Budget	Allowable	Not Allowable
PI Salary	X
Post Doc Salary	X
Administrative Support		X
Supplies	X
Equipment	X
Software	X
Personal Computers	X
Mailing	X
Tuition	X
Travel *	X
Research Staff Support (e.g. SRA; Lab. Technician)	X
Patient Care		X
Indirect Costs (26%)	X
Others Expences **	X

*Travel for awardees is restricted to attendance at conferences where the awardee is presenting or
**Refer to UCSF Charging Practices for examples of allowable expenses http://acctg.ucsf.edu/extramural_funds/policies/Practice.htm#NonPayrollExps
***Refer to UCSF Charging Practices for examples of unallowable expenses http://acctg.ucsf.edu/extramural_funds/policies/Practice.htm#UnallowedExps

10. Budget Justification: justify all costs fully.

11. BioSketch of Principal Investigator and UCSF Faculty Mentor(s) : Use NIH 398/2590 Biographical Sketch format page (http://grants.nih.gov/grants/funding/phs398/biosketch.doc.

12. Mentor's letter of support: Attach a letter of support from your mentor(s) that includes information outlined below:

•  Specific areas in which mentoring will be provided/mentor's role on the project
•  Mentor's background in mentoring
•  Describe how the project fits with the mentor's research agenda and mentee's career development
•  Describe mentor's working relationship (previous and/or current) with applicant

13. Letter of Support: Please provide a letter of support from the department chair or other unit head. For all applicants, department chair/unit head should indicate support for the application with signature. In addition, for junior investigators, department chairs/unit heads should comment on the independence of the applicant and availability of lab space and other resources for the proposed research.

Note to all applicants: If your proposal is selected for funding, the following will be required

1. Human Subjects . All research involving patients or cohorts, including the use of specimens/samples /medical record data requires CHR approval. If coded samples or data are used, a CHR waiver will be required (see http://www.research.ucsf.edu/chr/Apply/AppTypes.pdf to determine which type of CHR application you will need to file):
• CHR date of approval/waiver
• CHR approval/waiver number
• Specify if pending
2. For projects with a foreign component. Supply the following:
• Country
• Project field site
• Foreign institution FWA number
• Foreign IRB date of approval and approval number (specify if pending)
3. Note: No animal subjects research is allowed