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Application for Research Assistance

Type of Funding Requested

1. Therapeutic Development - $5,000 to $10,000
2. Evidenced Based Development - $20,000 and upwards
3. Research Support - $5,000 to $10,000
4. Clinical Fellowship (Note only 1 page narrative outlining need for support required after completing first 4 cells below) - $1,000 to $5,000

Name of Principal Applicant

Position and Title

Address

Email and Phone

Proposed Project

A one to three page project narrative describing how the research is innovative and will advance the objective of developing effective treatments for autism spectrum disorders. Include background, specific aims, research strategy, innovation and impact

Statement of Work

A one page narrative describing how the specific aims of the investigation will be accomplished including timelines, outcomes, products and deliverables for the investigation

Supporting Documentation

May be omitted if not applicable or include references, graphs, tables, photographs or other relevant information

Research and Budget

Please provide documentation for budgetary expenses in U.S dollars. Note: These awards may not be applied to indirect costs or administrative overhead.

IRB Approval

Please attach or describe status

Email this page (Word format) and supporting documents to ResearchPartners@autism.com.