Section
Study Title
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Principal Applicant Information
Name of Principal Applicant
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Primary institution, department and/or faculty
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Email Address
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Are you a CanVECTOR member?
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Select a value Yes No
List all Co-Applicants, including 4 details for each: 1) Name, 2) Career level, 3) Role, 4) Primary institution
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Pilot study start date (yyyy/mm/dd):
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Pilot study end date (yyyy/mm/dd):
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Total budget requested (CAD):
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Institution to manage awarded funds
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Does the proposed pilot study involve prospective randomization of patients to two or more interventions?
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Select a value Yes No
If you answered no to the previous question, describe the study design and confirm that the purpose of the pilot study is to evaluate the feasibility of a future randomized controlled trial by addressing issues of uncertainty
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Equity, Diversity, and Inclusion (EDI): How will EDI be considered for the pilot study? (Max 200 words)
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Sex and Gender: How will Sex and Gender be considered for the pilot study? (Max 200 words)
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Pilot Proposal (maxiumum 4 pages)
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References
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Lay summary (maximum 1 page)
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Budget and budget justification (maximum 2 pages: spreadsheet + justification)
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I certify that the information in this application is complete and true, and I will provide supporting evidence as required.
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Select a value Yes No
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