77 Ill. Adm. Code 970.330
Application Procedures for Research Concerning Breast Cancer
Section 970.330 Â Application Procedures for Research
Concerning Breast Cancer
The Department will provide written application instructions
and forms to potential applicants upon request. Information concerning the
grant will be available on the Department's website, http://www.idph.state.il.us/fundop.htm
.
a)Â Â Â Â Â Â Â Â All
applications shall include the following:
1)Â Â Â Â Â Â Â Â The
principal investigator's name, address, and telephone and FAX and
teletypewriter (TTY) numbers, if available;
2)Â Â Â Â Â Â Â Â The
name, address, and telephone and FAX and TTY numbers, if available, of the
entity (such as a university) through which the application is being submitted,
if different from the information provided in subsection (a)(1) of this
Section;
3)Â Â Â Â Â Â Â Â The
curriculum vitae of the principal investigator;
4)Â Â Â Â Â Â Â Â A
one-page non-technical abstract, which describes the significance of the
applicant's project for breast cancer research;
5)Â Â Â Â Â Â Â Â The TIN;
6)Â Â Â Â Â Â Â Â The
signature of the principal investigator or agency official authorized to
certify the application;
7)Â Â Â Â Â Â Â Â An
approximate timetable for project completion;
8)Â Â Â Â Â Â Â Â A
detailed budget for the funding period, documenting sufficient resources to
carry out the project. Â The budget shall be by line item category and shall
provide sufficient detail to justify the use of grant funds to support project
activities. The applicant shall indicate the total cost of conducting the
projects, the anticipated funding request for years two and three of the
project (if applicable), the source of other funds supporting the projects,
and the amount of support requested from the Department;
9)Â Â Â Â Â Â Â Â A
signed Statement of Assurances indicating compliance with applicable State and
federal requirements, such as the Fiscal Control and Internal Auditing Act,
Office of Management and Budget (OMB) Circular A-128 (local governments), OMB
Circular A-133 (not-for-profit organizations), bribery certification, contract
debarment, unlawful discrimination, Illinois Human Rights Act, The Civil Rights
Act of 1964, The Drug-Free Workplace Act of 1988, The Davis-Bacon Act of 1931,
conflict of interest as specified in the Illinois Procurement Code [30 ILCS
500], and protection of the confidentiality of services;
10)Â Â Â Â Â Â Â Â A
statement of whether funds are being requested for a fellowship or a general
award;
11)Â Â Â Â Â Â Â Â A
statement of the research question or hypothesis, or a description of
interventions or model programs on which the research will be based;
12)Â Â Â Â Â Â Â Â A
prioritized listing of measurable objectives for the funding period;
13)Â Â Â Â Â Â Â Â For
each objective proposed for the first year of the project, a sequential listing
of activities to achieve the objective, the time line for completing each
activity, identification of the individual responsible for coordinating the
implementation of each objective; and
14)Â Â Â Â Â Â Â Â The
evaluation methods to be used to measure progress in achieving objectives and a
plan for monitoring the overall project.
b)Â Â Â Â Â Â Â Â If
the funds are being requested to support a fellowship, the following
information shall be provided, in addition to the information required in
subsection (a) of this Section:
1)Â Â Â Â Â Â Â Â The
name of the individual to be supported through the fellowship;
2)Â Â Â Â Â Â Â Â The
curriculum vitae of the individual; and
3)Â Â Â Â Â Â Â Â At
least one letter of recommendation from the principal investigator or agency
official authorized to certify the application.
c)Â Â Â Â Â Â Â Â All
continuation applications shall contain the information required in subsection
(a) and, in addition, shall include the following:
1)Â Â Â Â Â Â Â Â A
progress report that contains a description of the status of each activity of
the project to date, utilizing the evaluation methods and monitoring plan
specified in subsection (a)(14) of this Section;
2)Â Â Â Â Â Â Â Â Documentation
of progress in meeting each project objective;
3)Â Â Â Â Â Â Â Â The
project objectives for the new grant year, along with activities and timelines
for completion of each activity; and
4)Â Â Â Â Â Â Â Â Any
revisions in the evaluation methods or the monitoring plan, along with the
rationale for such revisions.