ࡱ> 9 )bjbj phh op p RRR$vvvPbve-2&^#<&$:$ ,,,,,,,$0M38 -RF$#"#F$F$ -D-&&&F$8R,&F$,&&:),:)@@b$L) ,5-0e-).3$3))83R(*F$F$&F$F$F$F$F$ - -%NF$F$F$e-F$F$F$F$3F$F$F$F$F$F$F$F$F$p X :  2023 Full Proposal Application Forms Funding Period: Feb 15, 2023 Feb 14, 2025 Award Amount: $500,000 over two years ($250,000 per year) TITLE OF PROJECT: KEY WORDS: APPLICANT DEPARTMENT OR DIVISION CHAIRName, Degree(s):Name, Degree(s):Academic/Research Title:Full Academic Title:Department:Department:Institution:Institution:Address:Address:Telephone:Telephone:Email:Email: INSTITUTION WHERE PROJECT WILL BE CONDUCTED:  HUMAN SUBJECTS Yes  FORMCHECKBOX  No  FORMCHECKBOX   VERTEBRATE ANIMALS Yes  FORMCHECKBOX  No  FORMCHECKBOX  AUTHORIZED INSTITUTIONAL REPRESENTATIVE INSTITUTIONAL OFFICER TO RECEIVE FUNDSName:Name:  Title:Title:Institution:Institution:Address:Address:Telephone:Telephone:Email:Email:CERTIFICATION: By signing this Face Sheet, we certify that the statements contained in this Application are true and complete to the best of our knowledge, and accept the Terms of the Award for the Edward N. & Della L. Thome Memorial Foundation Awards Program in Age-Related Macular Degeneration Research. The Applicants signature also confirms responsibility for obtaining any animal use, human subjects and/or other required institutional approvals.  Signature of Applicant Date: Signature of Authorized Institutional Representative Date:  Contact: The Medical Foundation at 91Ů  HYPERLINK "mailto:ThomeAwards@hria.org" ThomeAwards@hria.org Revised 9/6/22 Table of Contents Application Face Sheet 1 Table of Contents 2 Research Project Summary & Performance Sites 3 Non-Technical Overview and Summary 4 Diversity, Equity, and Inclusion Statement 4 Research Proposal (maximum of ten pages) Background and significance Specific aims Preliminary data (if available) Research design, experimental methods, and analytical plan Research limitations and contingencies References cited (not part of page count) Projected Milestones and Research Plan Table.. Budget and Other Support Form *Excel template: www.tmfgrants.org/ThomeAMD Biographical Sketch of PI (and Co-Investigator(s), if applicable) Department / Division Chairs Letter Letters of Collaboration(s) (if applicable). Research Project Summary The Project Summary is a 300-word scientific abstract stating the project's broad, long-term objectives and specific aims. Describe concisely the research design and methods for achieving these goals. Use the same Project Summary for both the Online Submission and this form. You may use the same Project Summary from your Initial Proposal submission or update it as needed. The Research Project Summary will be posted on our website if the project if funded. Key Words: Project Summary:  Performance Sites (Institution, City, State):  Non-Technical Summary Prepare a lay-language description of the proposed research that can be understood by the general public. This statement should match the text in the corresponding field for online submission. (200 words)  Non-Technical Overview Please answer the following questions in ONE SENTENCE EACH, in terms understandable to a non-specialist. This statement should match the text in the corresponding field for online submission. What big question(s) will your work answer? Why does this question matter? How will your work answer the big question?  Diversity, Equity, and Inclusion Statement Please include a description of your commitment to improving diversity, equity, and inclusion. This statement should match the text in the corresponding field for online submission. (250 words)      Edward N. & Della L. Thome Memorial Foundation Awards Program in Age-Related Macular Degeneration Research   $%)*:>?@DEFILMOTUWbֽ֤֤ujuuuu_T_h1*6CJOJQJh6CJOJQJhh6CJOJQJh7-6CJOJQJhS6CJOJQJh3K6CJOJQJh1*h6CJOJQJh1*h1*5CJOJQJh7-5CJOJQJhh5CJOJQJh1*h1*5CJOJQJh1*5CJOJQJ h* 6CJOJQJmHnHujh* UmHnHu* H$If^Hgdh). $Ifgdh). 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