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SI Network Small Project Grant Application form www.sensoryintegration.org.uk document.docx2015 1 of 12

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Page 1:  · Web viewHave you completed the Sponsor Declaration: Y/N Address of institution Cost Please present an estimated breakdown and the total cost of your project/research. Please only

SI Network Small Project Grant Application form

Please refer to the application guidance notes when completing this application form.

www.sensoryintegration.org.uk

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Page 2:  · Web viewHave you completed the Sponsor Declaration: Y/N Address of institution Cost Please present an estimated breakdown and the total cost of your project/research. Please only

Title of Proposed Research

www.sensoryintegration.org.uk

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Page 3:  · Web viewHave you completed the Sponsor Declaration: Y/N Address of institution Cost Please present an estimated breakdown and the total cost of your project/research. Please only

Applicant detailsName of Applicant:

Current job title:

Professional/Research and SI qualifications/experience:

SI Network Membership No.:

Contact address:

Email:

Telephone:

Co-applicant(s):

Current job title:

Professional/research and SI qualifications/experience:

Contribution to project:

Contact address:

Email:

Telephone:

Institution / organisation supporting application:

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Page 4:  · Web viewHave you completed the Sponsor Declaration: Y/N Address of institution Cost Please present an estimated breakdown and the total cost of your project/research. Please only

Sponsor Details:

Name of Supervisor/Sponsor

Name of Institution supporting application

Have you completed the Sponsor Declaration: Y/N

Address of institution

Cost

Please present an estimated breakdown and the total cost of your project/research. Please only include those permissible in accordance with the T&C’s.

Equipment:

Materials: Training/ CPD event

Researcher’s time/ additional staff

Total Cost: (£/Euro)

Materials

Dissemination

Total Cost: (£/Euro)

4. Proposed timeline of Project

Start date:

End date:

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5. Other applications for funding

Date submitted

Funding body Value Date outcome will be known

Stipulate which SI Research Strand your study relates to:

Evidence from within the field of Neuroscience Assessment and Measures of SI and Sensory Processing Difficulties Evidence for the treatment of Sensory Processing Difficulties:

-Ayres Sensory Integration Therapy -Sensory Strategies.

Explain how your project/conference presentation addresses the identified priority area:

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Lay summary (word limit: 200)

8. Expected value of findings

9. Conference Attendance

Conference Title:

Date/s of Conference:

Type of Presentation (Paper/Poster/Workshop/Seminar)

Justification/rationale for applying for funding to attend Conference:

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Website address of Conference:

www.sensoryintegration.org.uk

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Background to the project (literature review) (word limit: 500)

www.sensoryintegration.org.uk

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Research Question, including aims of study

Study design and methodology (word limit: 500)

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www.sensoryintegration.org.uk

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Ethical considerations

Methods of dissemination

References

www.sensoryintegration.org.uk

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www.sensoryintegration.org.uk

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Page 13:  · Web viewHave you completed the Sponsor Declaration: Y/N Address of institution Cost Please present an estimated breakdown and the total cost of your project/research. Please only

Declarations a) Applicant

I declare that I have completed the application form in accordance with the SI Network guidance notes. I have read and will comply with the SI Network Terms and Conditions and consent to the information I have provided in this application being used accordingly. If successful, I agree to acknowledge the S.I. Network UK & Ireland on all publications and to publish a summary of the study, including the results, in Sensornet and/or a peer reviewed journal and to be prepared to present at the SI Network annual conference. I consent to my results may be used for education purposes, for which I would be acknowledged. I also agree to advise SI Network of any change to my work role which might affect the research.

FULL NAME:

INSTITUTION:

SIGNATURE:

Date:

b) Co-applicant(s) (duplicate as necessary)

I declare that I will participate in the project described in this document as a co-applicant should the application be successful.

FULL NAME:

INSTITUTION:

SIGNATURE:

Date:

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