The Royal Children's Hospital Foundation Proposal for Funding

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Please DO NOT USE internet explorer with this form as certain features will not work with the RCH browser version.

Please ensure that you have discussed your intended proposal for funding with the following people prior to making your submission;

* Head of Department

* Management Accountant

* Executive Director

* Procurement and Biomedical Engineering (if for equipment)

* MCRI Theme Director (if for research)

* Project Reference Group (if your proposal involves implementing a new model of care / changing the delivery of a service / implementing a quality improvement project / developing educational resources / implementation of an IT system / changing a current system)



Used as a reference for all communications. Max 80 Characters
FUNDING SUMMARY

Enter an amount with decimal places. Don't add commas. Please update this field if the budget does not match

SPF Cost centre that will bear the costs of the program/project/equipment





Max 255 characters
SUBMISSION DETAILS

Person completing this form and who agrees to take responsibility for this proposal on an ongoing basis. See further info in the guidelines on the Foundation's website.





Please ensure your email address is correct as all communications will be sent to this address. This needs to be your RCH campus email address.

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PROPOSAL DETAILS

JUSTIFICATION FOR PROPOSAL
  • Describe your project
  • How will it be delivered (i.e how are you going to do it?)
  • Include specific benefits and impact on patients and the RCH  
  • How will it impact the future of children's health?
  • How does your proposed activity fit with other initiatives within the department/hospital/campus?
5000 characters maximum

RCH STRATEGIC PLAN
  • Describe how your proposal aligns with the RCH Strategic Plan
  • Which RCH Strategic Priority does this project address and how?
2000 characters maximum

EXPECTED OUTCOMES
  • What are the expected outcomes?
3000 characters maximum

KEY PERFORMANCE INDICATORS
  • What measures will be used to determine the success of the outcomes identified above?
  • Please list at least three KPI's (where applicable) and detail what change in performance/outcome of that measure would mean a successful outcome
3000 characters maximum

RESEARCH

If you are not applying for research funding - please enter N/A

If you are applying for research funding;
  • Has the project been submitted for NHMRC / ARC funding?
  • Has the project been submitted for near miss funding?
  • Please provide a letter of support from your Theme Director highlighting how this research fits within the strategies of the Murdoch Childrens Research Institute
Provide a brief lay summary on the aims, methods, results, expected outcomes.

For all research proposals please attach the following for scientific review:

  1. Background information in sufficient detail to justify the need for the project
  2. Details of any pilot work completed
  3. Detailed research plan, including design, details of participants, measures and statistical analyses
  4. Plan for translation of study results into clinical practice
  5. Full list of investigators, their expertise and what they will contribute
  6. Full list of investigators publications over last 5 years
  7. Full list of Grants applied for over the last 5 years
  8. Full list of Grants awarded over last 5 years

4000 characters maximum

FUNDING
  • To the best of your knowledge, is the submission the subject of tied funds; that is funds from a particular donor/donor group?
  • Why is this proposal not funded from other sources (e.g. Government, RCH operating or MCRI theme funding if research)? 
2000 characters maximum
3000 characters maximum

END OF FUNDING SUPPORT
  • Detail what will happen at the end of the funding support (i.e. will your project be self-sustainable? will your project cease?).
  • Explain your vision of sustainability for this program beyond RCH Foundation funding
  • If the project is multi-year and involves salaries, please advise how it will become sustainable beyond the proposed funding period. Please also consider how funding might step down during the course of the funding period through other grants or funding sources.

3000 characters maximum

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Each item included in your proposal should be listed separately. For example, a $10,000 proposal may include 2 items worth $4000, and another at $2000. Please use the ‘Add another ... Item’ function to list these details.

Applicant must ensure that the Management Accountant has been consulted prior to completing this section.

Budget for Non Salary Items





Assists the RCH Foundation to determine when you would require the distribution.

If this request includes clinical equipment, please indicate an estimated life of the asset

Will be subtracted from the total cost to derive the amount applied for

If you need to add another non salary item, click 'Add another Non Salary Item' below
Budget for Salary Items




If your request is for salaries over multiple years, enter a separate item for each year that the position will be funded.



Will be subtracted from the total cost of employment to derive the amount applied for




If you need to add another salary item, click 'Add another Salary Item' below










Add any further supporting information (3000 characters maximum)


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DECLARATION OF INTEREST
Our goal is to ensure your work is not compromised in any way. We therefore ask all applicants to disclose any potential conflicts before submission. This avoids any post submission issues and claims of conflict.








Final Declaration
By submitting this application, I affirm that the information put forward is true and complete. I understand that if my project/initiative is accepted for funding, any false statements, omissions, or other representations made by me/us on this application may result in a refusal of funds. I am also aware that an acquittal is required on completion of the project (annually for multi-year grants).

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