EXAMPLE COMPLETRED BSAC GRANT APPLICATION FORM

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EXAMPLE COMPLETRED BSAC GRANT APPLICATION FORM PLEASE TYPE DIRECTLY ONTO THIS APPLICATION FORM. Please use Arial font size 10. PRIORITY CALL FOR 2018 RESEARCH GRANT APPLICATIONS (for grants to be awarded in May 2019). The BSAC is giving priority to fund applications focused on the following specific areas of interest below. SPECIFIC AREAS OF INTEREST (tick ALL areas that apply to your project / application): 1. Diagnostics: More optimal/effective use of antimicrobials through PK/PD in clinical practice Prognostic markers of bacterial infection (i.e. when is an antibacterial indicated?) Prognostic markers of infection with microorganisms resistant to first-line empirical treatment regimens (i.e. when is a broad-spectrum antibacterial indicated?) Can better use of existing or new laboratory diagnostics including biomarkers support better stewardship across healthcare communities, with special reference to Virology? 2. Antimicrobial Stewardship: The impact of resistance or antimicrobial consumption surveillance on patient outcomes in community, long term care and acute facilities Innovative promotion of behaviour change science in prescribing in all healthcare settings Impact of educational solutions/ guidelines etc. on stewardship practice / infection treatment outcomes [could be systematic review] Impact of sepsis campaigns on optimal antibiotic use / stewardship or use of older agents used in stewardship on clinical outcomes 3. Virology: Targeting viruses with pre-existing resistance to licensed therapies 4. Antibiotic adjuvants: Antibiotic adjuvants i.e. resistance breakers (such as efflux pump inhibitors, uptake enhancers e.g. polymyxin B nonapeptide) 5. Molecular mechanisms of antimicrobial resistance (including bacteria, fungi, parasites and viruses) 6. Informatics: Computational approaches to understand and combat antimicrobial resistance, including global epidemiology of infectious diseases and antimicrobial resistance, computer aided drug design, electronic approaches for improved antimicrobial stewardship WHEREVER POSSIBLE PROJECTS SHOULD BE CROSS DISCIPLINARY AND TAKE ACCOUNT OF THE ONE HEALTH AGENDA. 1

Applications can also be submitted under the usual BSAC areas of interest listed below. GENERAL AREAS OF INTEREST (please tick ALL areas that apply to your project / application): Mechanisms of bacterial action Mechanisms of antibacterial resistance Antiviral resistance Antivirals Antifungal Antibiotic methods Antibiotic prescribing Antibiotic therapy Antiparasitics Evidence based medicine / Systematic reviews APPLICANT(S) DETAILS: Enter details for all applicants. NOTE: the first set of details entered to the table below will be considered as those for the principal (lead) applicant. DEPARTMENT AND INSTITUTE DETAILS FOR THE PRINCIPAL (LEAD) APPLICANT: Please add rows as necessary. ADDRESS: THE BSAC 53 REGENT PLACE POSTCODE: B1 3NJ PHONE: +44(0) 121 236 1988 EMAIL: FORENAME SURNAME AGE POSITION HELD DEGREES THE BSAC 47 ABCD PHD 2

PROJECT DETAILS Applications must be a maximum 5x A4 pages outlining the investigation & including up to 15 references, excluding the Application from, the signed Terms and Conditions form and abridged CVs. TITLE OF PROJECT: Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor Applications must be submitted with pages set in the precise order below* 1. This Application form (4 pages completed in full, do not split or alter page layout) 2. Supplementary information on maximum 5x A4 pages: Abstract Background Hypotheses to be investigated Aims of proposed research project Plan of investigation GANNT chart / timetable for proposed research (including start date) Reasons for applying to the BSAC Costs, with justification for all costs. Applicants must include the total amount of funds being requested in GBP/UK currency References (no more than 15 in total) Abridged CVs for all applicants named on the application form (maximum 2x A4 pages, including a clear statement of track record in this area and details of recent publications) 3. A signed copy of the BSAC Terms and Conditions form (before making an application all applicants are advised to read all Terms and Conditions and Standard Operating Procedures found at: BSAC T&Cs/SOPS) *Applications not submitted with pages set in the order outlined above will be returned to the applicant for revision DECLARATIONS: BSAC does not currently offer co-funding of grants. When applying for any BSAC grant, all applicants must declare if they have sought, or if they intend to seek, any financial support outside of BSAC for the same grant. BSAC must be informed of any grants awarded outside of BSAC funding and the application withdrawn immediately. Has this application been submitted elsewhere for funding? Yes No If yes, please provide full details below: INSERT DETAILS Please list all grant support received in the last 5 years for all applicants who are named on this application form (including the total amount of funding received for each grant listed; and noted in GBP/UK currency). INSERT DETAILS Please list all submitted grant applications for all applicants who are named on this application form, and for which the decision is not yet known (including the total amount of funding requested for each grant listed; and noted in GBP/UK currency). INSERT DETAILS 3

ESTIMATED PROJECT START DATE: INSERT DATE HOW TO APPLY: Applications must be submitted online at: www.bsac.org.uk Applications must include all supplementary information as outlined, and in the exact order requested, under the Project Details section on page 3 of this document. *Applications not submitted with pages set out in the order outlined on page 2 will be returned to the applicant for revision. Applications submitted by email will not be accepted. TERMS AND CONDITIONS: The Terms and Conditions for all BSAC Grants and Scholarships are published on the BSAC web site at: www.bsac.org.uk Applicants and host institutions are required to read all terms and conditions for BSAC grants before completing this form. Both the lead applicant and a representative of the Finance Department of the host institution must sign this form. Electronic signatures are accepted. WE HAVE READ, UNDERSTOOD AND ACCEPT ALL TERMS AND CONDITIONS: Signed (Lead Applicant): THE BSAC Name (PLEASE PRINT): THE BSAC Date: Insert date Signed (Finance Department): BSAC FINANCE Name (PLEASE PRINT): BSAC FINANCE DEPARTMENT Date: Insert date 4

Abstract Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Background Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut. Hypotheses to be investigated Aims of proposed research project Plan of investigation GANNT chart / timetable for proposed research MONTHS 1 2 3 4 5 6 7 8 9 10 11 12 INSERT ROWS AS NECCESARY Reasons for applying to the BSAC 5

Costs, with justification for all costs. Applicants must include the total amount of funds being requested in GBP/UK currency Costs, with justification for costs ITEM COST (GBP/ ) ITEM 1 ITEM 2 ITEM 3 INSERT ROWS AS NECESSARY TOTAL References (no more than 15 in total) 1. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut 2. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut 3. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut 4. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut 5. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut 6. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut Abridged CVs for all applicants named on the application form (maximum 2x A4 pages, including a clear statement of track record in this area and details of recent publications) APPLICANT 1 APPLICANT 2 APPLICANT 3 APPLICANT 4 A signed copy of the BSAC Terms and Conditions form (before making an application all applicants are advised to read all Terms and Conditions and Standard Operating Procedures found at: BSAC T&Cs/SOPS) 6