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Research Proposal Form

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Research Proposal- Safety, Efficacy and Cost-Effectiveness of Supplementing Intermediate Term, Cold Storage Media with Amphotericin

  • Proposal Form

    In response to the reported increased incidence of postkeratoplasty fungal infection, the Eye Bank Association of America is currently accepting investigator and industry-initiated proposals focused on the safety, efficacy and cost-effectiveness of supplementing intermediate term, cold storage media with amphotericin. Please use the spaces and upload buttons below to submit your proposal.
  • Title of Research Proposal

  • Principle Investigator Information

  • Name of Principle Investigator
  • Designation (MD, PhD, MS, CEBT, etc)
  • Organization/ Institution/ Company
  • Position/Job Title
  • Phone Number
  • Email Address
  • Organization/ Institution Address
  • Principal Investigator CV/Bio Sketch. Please upload your CV/Bio Sketch here.
    Drop files here or
    Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

    • Eye Bank or Paton Society Affiliation

    • Eye Bank Affiliation
    • Relationship with Eye Bank (Please describe)
    • Paton Society Member Endorsement: If you are not affiliated with an eye bank, please enter the name of the Paton Society Member who supports your project. Please include a letter of support.
    • Paton Society Letter of Endorsement: This is only required if the project is not associated with an eye bank or Paton Society Member.
      Drop files here or
      Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

      • Scientific Supervisor Information

        Needed for applicants-in-training, eye-bank technicians, and nurses
      • Scientific Supervisor Name (if applicable)
      • Organization/ Institution
      • Email Address:
      • Scientific Supervisor CV/Resume
        Drop files here or
        Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

        • Co-Investigator Information

          Please list the information for each co-investigator on the project.
        • Co-Investigator #1 Name
        • Co-Investigator #1 Organization/Institution
        • Co-Investigator #2 Name
        • Co-Investigator #2 Organization/ Institution
        • Co-Investigator #3 Name
        • Co-Investigator #3 Organization/Institution
        • Co-Investigator #4 Name
        • Co-Investigator #4 Organization/Institution

        • Grant Award Information

        • Total Budget Requested (Max. of $25,000)
        • Name of Organization to which award should be made.
        • Address where Grant Funds will be sent:

        • Research Proposal

          Each proposal must include: • Background and Specific Aims of the project (Max Length: 1 page) • Significance (Max length: 1 page) • Methods / Approach (Max length: 3 pages) • Qualifications & Facilities (Max Length: 1 page) • References (Max length: 2 pages)

        • Background & Aims

          Background & Aims. State the background of the project and the specific aim(s) of this study. Include the information in the space below or upload the information using the tool below. (Max Length: 1 page)
        • Background & Aims. State the background of the project and the specific aim(s) of this study.
        • Background & Aims. Please upload the document related to the background and aims of the research proposal here.
          Drop files here or
          Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

          • Significance

            Use this section to state the significance of this project to eye banking and/or corneal transplantation.
          • Significance. Explain the significance of this project to eye banking and/or corneal transplantation.
          • Significance. Upload your documents detailing the significance of this project.
            Drop files here or
            Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

            • Methods & Approach

              Provide a concise research plan that includes a description of the methodology and approach that will be used. Relate the research techniques directly to the specific aim(s). Include the information in the space below or upload the information using the tool below. (Max Limit: 3 pages)
            • Methods & Approach. Provide a concise description of the methodology and approach that will be used. Relate the research techniques directly to the specific aim(s). (Limit: 3 pages)
            • Methods & Approach. Upload a document that outlines the research plan including the methods and approach.
              Drop files here or
              Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

              • Qualifications & Environment

                Use this section to include your qualifications to carry out this study and the facilities and resources available to you for this study. Include the information in the space below or upload the information using the tool below. (Max Limit: 1 page)
              • Qualifications. What are your qualifications to carry out this study? (Word limit: 500 words)
              • Environment. How is the environment at your organization/institution/company conducive to carrying out the proposed study? Include the facilities, personnel, resources, and infrastructure that are available to you and how they will help with the conduction of this study. List responsibilities of key personnel pertaining to this study. (Word limit: 500 words)
              • Please list any other funds/resources that you have received to assist in the completion of this study (e.g., technician support, equipment, etc.)? List all grant applications pertinent to this study that are currently submitted or planned within the next year. (Word limit: 250 words)
              • Use this tool to upload a document detailing your qualifications and the facilities and resources available to you to the carry this study.
                Drop files here or
                Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

                • Budget

                  Provide a detailed itemized budget for the proposed project. List the budget in the space below or upload using the tool below. (Max Length: 1 page)
                • Budget: Itemize all proposed expenditures. Provide a brief justification for any item for which the need may not be obvious. (Max Length: 1 page)
                • Upload your itemized budget here.
                  Drop files here or
                  Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

                  • References

                    References. Include all projects and papers that are being referenced in producing this research. (Max Limit: 2 pages)
                  • References. Upload list of references here.
                    Drop files here or
                    Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

                    • Supporting Documents

                      Supporting Documents. Include any additional documents (including tables and figures) that support your proposal.
                    • Supporting Documents. Include any additional documents, tables, etc, here.
                      Drop files here or
                      Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

                      • Research Safeguards

                      • It is the policy of the Eye Bank Association of America that institutions and organizations using experimental animals in projects or demonstrations supported with funds from EBAA grants shall assure the EBAA in writing of compliance with the Principles for Use of Laboratory Animals as stated in the regulations of the Department of Health & Human Services.
                      • Safeguarding the rights and welfare of human subjects involved in research supported by the Eye Bank Association of America is the responsibility of the institution to which the support is awarded. It is the policy of the Eye Bank Association that no grant to support research involving human subjects be made unless the research is given initial and continuing review and approval by an appropriate committee of the applicant's institution. This review should assure that (a) the rights and welfare of the individuals involved are adequately protected, (b) the methods used to obtain informed consent are adequate and appropriate, and (c) the risks to the individual are outweighed by the potential benefit of him or her by the importance of the knowledge to be gained.
                      • Consent Forms & IRB Approval: If applicable, please upload copies of the consent form and IRB approval statement.
                        Drop files here or
                        Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.

                        • Acknowledgement of Terms

                        • Acknowledgement of Terms. If the project is approved for support, I agree to the following: (Please check each box)
                        • Please check this box if all of the information in this application is correct and complete.
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