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‫המכון הלאומי לפסיכוביולוגיה בישראל‬
‫נוסד ע"י משפחת צ'רלס סמית‬
The National Institute for Psychobiology in Israel
Founded by The Charles E. Smith Family
Tel: 02-6584086 Email: [email protected]
___________________________________________________________
Application No. ______________________
Young Investigator Research Grant Application
( ) New Application
( ) Request for Second Year
Title of Project:
:‫שם החוקר‬
Principal Investigator:
Academic Title:
Date of Appointment:
Institute and Department:
Tel:
Fax:
Email:
Names and Affiliations of Other Participating Investigators:
Duration of Support Required:
Start Date ………………
Date:
Insitute's approval:
(e.g. Dean, Director of Hospital, etc.):
______________________
Signature
1 Year / 2 Years (Circle)
End Date …………….. (month/year)
Signature of Applicant
The Charles E. Smith Fellowship in Honor of
Professor Joel Elkes
__________________________________________________________________________________
This Fellowship is awarded to one of the applicants for a Young Investigator Grant.
The purpose of the Fellowship is to assist in absorption of a young scientist in the
field of psychobiology into a track which will lead to a permanent academic position
upon completion of the 3-year period of the Fellowship.
Are you applying for this Fellowship? _________________
If so, you must be nominated by your Institution. The nominator must explicitly
commit to the effect that at the end of the period of the fellowship, a permanent
position will be made available to you, based upon your personal distinction in
research and teaching. He or she must also submit 3 letters of recommendation
In addition, please explain on the Budget page how you would use the additional
funds (i.e. total, Psychobiology Institute plus institution matching funds, of $50,000
instead of $25,000.)
Special Young Investigator Grants
__________________________________________________________________________________
The Drug Abuse Research Grant in Memory of Steven Smith
Within the framework of the preferential funding of research grants by the Institute, a
research grant has been established by Mr. David Smith in memory of Mr. Steven
Smith. The grant is designated for financing a research project in the area of drug
abuse with emphasis on topics such as prevention and treatment of sufferers of drug
abuse. Financial support is similar to that of regular Young Investigator Grants.
Are you applying for this Grant? _________________
If so, please attach a letter stating why you are suited for this particular grant.
Clinical Research Grant in Memory of Haim and Regina Rabinowitz
Within the framework of the preferential funding of research grants by the Institute, a
research grant has been established by the Prince and Eliaouf families in memory of
Chaim and Regina Rabinowitz. The grant is designated for financing a research
project in the area of clinical psychiatry with emphasis on topics such as depression,
schizophrenia, anxiety and disorders related to or induced by military service.
Financial support will be similar to that of regular Young Investigator Grants
Are you applying for this Grant? _________________
If so, please attach a letter stating why you are suited for this particular grant.
2
Other Research Support
__________________________________________________________________________________
Active Grants
Do you have other active research grants (as Principal or Co-investigator)?
Yes / No
If Yes, please provide the following information separately for each grant on the
following page:
1. Source 2. Subject of grant 3. Start and end dates (Month / year).
4. Your role (if you are a Co-Investigator, please also give the name of the Principal
Investigator).
5. Total sum of grant and sum for current year.
6. Relationship of the grant subject to the subject of the present application (if not
related, please state).
Pending Grants
Have you submitted other grant applications on this or other topics?
Yes / No
If Yes, please provide the following information separately for each application, on
the following page:
1. Source 2. Subject of application 3. Start and end dates (Month / year).
4. Your role (if you are a Co-Investigator, please also give the name of the Principal
Investigator).
5. Total sum of application and sum per year. 6. Relationship of the application
subject to the subject of the present application (if not related, please state).
3
Details of other research support (active and pending)
__________________________________________________________________________________
4
Keywords
ADHD
Aging
Alcohol/substance use disorders
Alzheimer's
Anxiety Disorders
PDD
Attention
Behavior
Behavioral Disorders
Brain Areas
Brain Disorders
Development
Dissociative Disorders
Eating Disorders
Impulse Control Disorder
Neuronal Circuits
Learning
Memory
Mental Disease
Mood Disorders
Mood Regulation
Movement Disorders
Neural computation
Neurobiology
Neurodegenerative Disorders
Neurodevelopment
Neuro Developmental Disorders
Neurogenesis
Neurostimulation
Neurology
Neuronal Modeling
Neuronal Processing
Neuropathy
Neurophysiology
Pain
Pervasive Developmental Disorders
Physiological Neuromechanisms
Plasticity
Psychotic Disorders
Psychiatry
Sensory Systems
Specific Developmental Disorders
Sexual Disorders
Sleep Disorders
Somatoform Disorders
Stem Cells
Stress
Tic Disoders
Toxicity
Transcription Factors
Others:
5
Abstract
(200 Words)
__________________________________________________________________________________
Keywords:
6
Abstract in Lay Language
(100 Words)
Please provide an abstract appropriate for a intelligent, but non-scientist, readership.
__________________________________________________________________________________
7
1. Research Objectives
(Items 1, 2, 3 and 4 must not exceed 10 pages).
__________________________________________________________________________________
8
2. Scientific and Technological Background
(Use continuation pages if needed)
(Not required for 2nd Year Application)
_____________________________________________________________________
9
3. Progress Report
(2nd Year Application only).
Please also list publications supported by the Institute and enclose a copy of each
__________________________________________________________________________________
10
4. Research Plan
(Methodology, plan of operation, time schedule, expected results and significance).
(If the application is for two years, describe plan for first year in detail and provide
outline only for second year).
(Use continuation pages if needed).
_____________________________________________________________________
11
5. Previous Experience of Applicant
(Applicants who have limited personal experience in the proposed area of research
should indicate here how and from whom guidance and consultation will be
available).
(Not required for 2nd Year application).
__________________________________________________________________________________
12
6. Resources
(Briefly describe the site(s) where the research project will be performed, equipment
available and other relevant resources).
(Not required for 2nd Year application).
__________________________________________________________________________________
13
7. Curriculum Vitae and List of Publications
((Not to exceed 3 pages).
(Only an update is required for 2nd year applications).
_____________________________________________________________________
14
8. Budget
__________________________________________________________________________________
*Salaries
____________________
*Consumable Supplies
____________________
*Animals
____________________
** Equipment
____________________
*Other expenses
____________________
Total
____________________
* Please specify.
** Please specify and justify. Will be granted in special cases only.
If you are applying for a Charles E. Smith Fellowship in honor of Prof. Joel Elkes,
please describe the use of the additional Budget that will be available. (see page 2)
Budget Justification
15