KONG Resident Research Grant Application

KONG Resident Research Grant Application

Sponsored by KONG Veterinary, administrated by The Veterinary Behavior Center. Email all questions to KONG_Research@vetbehaviorcenter.com
Primary Investigator Information

Please provide details about the primary investigator.
Full Name of Primary Investigator*

First NameLast Name
Your Email Address*
example@example.com
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Degrees obtained and institutions*
Current Institution/Practice*
BehaviorAnimal WelfareShelter MedicineOther
If other, which residency?
Residency Start Month/Year*
Anticipated Residency Completion Month/Year*
Resident Mentor(s) Name(s)*
Provide verification of your status as a resident. Options include: letter from your residency mentor, letter from your college board, program acceptance letter, etc. *

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Has the primary investigator ever been sanctioned or violated any previous IACUC or IRB approved programs? If so, explain:*
Research Mentor/Supervisor Information

Provide details about the research mentor or supervisor.
Research Mentor/Supervisor Name*
Title and Credentials of Research Mentor/Supervisor*
Institution of Research Mentor/Supervisor*
Research Mentor/Supervisor Email*
example@example.com
If your research mentor is not the same person as your residency mentor, please provide an additional letter of verification from your research mentor as to their role:

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Planned co-investigators list (aside from you, your research mentor +/- your residency mentor, please list any other co-investigators. if applicable)
Conflicts of Interest (if any)
Co-sponsors and Contributions (if any)

EXPECTED IMPACT

Questions on Clinical Applications and Dissemination Plan including target journals, conference plans, and educational materials.
Describe the clinical applications of your research*
Describe your dissemination plan including target journals, conference plans, and educational materials*

KONG Product Request

KONG is happy to provision products for use in studies in addition to the financial stipend at no charge. Need for product will NOT put you at a disadvantage in this application process.
KONG product request (if any) and quantity:
YesNo
Address To Deliver KONG Products:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

BUDGET AND JUSTIFICATION

Budget Summary and funding details.

Budget Summary*

Rows	Personnel	Supplies	Animal-Related Costs	Services	Travel	Other Direct Costs	Indirect Costs	TOTAL
General Description
Expected Budget

Describe needed equipment and facilities or resources that you have access to at no fee or has already been provisioned:*
List any additional approved funding sources*
List additional funding being sought*

TIMELINE & MILESTONES

Planned timing of your project
Project Timeline and Milestones

OPTIONAL ATTACHMENTS

Attachments provided here help us understand how far along you are in the process and how likely you are to complete the project. Provide anything you think would be helpful for us to look at. This is not required.
Letters of Support:

Include any applicable letters or approvals that substantiate your efforts to complete this project:
- Collaborating institutions or veterinarians (if outside your clinical practice)
- Industry partners (if products or laboratory tests are being provided at no charge)
- Any special approvals (e.g. international certificates, export/import, etc.)
- Other key personnel
File Upload*

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Other Appendices

Include anything else that demonstrates your progress with the project:
- Supplementary data
- Validated instruments you are relying on
- Approval for other funding
- Consent forms created
- Protocols established
- Any data graphs
- anything else!
Upload here:

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Submit your application!
By signing and submitting, you are verifying that all information contained herein represents an honest and truthful reporting, of your design, without plaigarism. You are verifying that this application is being submitted with full intention to complete the research proposed and to publish. You understand you will be expected to provision to KONG completion reports that they may utilize if they desire for their own purposes.
Signature*
Date*

MonthDayYear
Should be Empty:

KONG Resident Research Grant Application

Primary Investigator Information

Research Mentor/Supervisor Information

PROJECT OVERVIEW

Background Research

Methods

Study Design

Statistical Analysis Plan

EXPECTED IMPACT

ANIMAL WELFARE AND ETHICS

Potential Risks and Benefits

KONG Product Request

BUDGET AND JUSTIFICATION

TIMELINE & MILESTONES

OPTIONAL ATTACHMENTS

Submit your application!