American Heart AssociationMartin B. Leon / Johnson & Johnson Cordis Corporation Research

Fellowship in Interventional Cardiology

Application Instruction and Guidelines

Founders AffiliateIncludes: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island and Vermont

Application deadline: March 16, 2009Award activation: July 1, 2009

Table of ContentsGeneral Information Peer Review Criteria for Fellowships Streamlined Review (Triage)..............................................................................................3 Process.....................................................................................................................4

Email Application Deadline.......................................................................................5Supplementary Materials...........................................................................................5Administrative Withdrawal Procedures................................................................................................................5Timeline (Submission to Activation)..........................................................................6

Tips for Fellowship Applicants...........................................................................................7

Application Checklist..........................................................................................................8Assembly of Paper Sets.....................................................................................................11

Font and Characters per Inch Requirements.....................................................................................................................12Body of Application

Project Summary form...............................................................................................13Definition of a Resubmission.....................................................................................13Project Personnel/Signatures form...........................................................................14Applicant Information form........................................................................................16Administrative Information form.................................................................................19Biographical Sketch (PI) form....................................................................................21Co-Authors/References form.....................................................................................21

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Reference Reports for Applicant form...........................................................................................................................22Academic Record of Applicant..................................................................................23Research Project Environment form.........................................................................24Project Budget form..................................................................................................24Funds Available form(s) (to be completed by Fellow)................................................................................................25Sponsor Packet.........................................................................................................26Co-Sponsor Packet...................................................................................................27Proposed Research Plan..........................................................................................28Vertebrate Animal Subjects.......................................................................................30Literature Cited..........................................................................................................31Biographical Sketch (Collaborating Investigator, if applicable).........................................................................................31Research Classification forms...................................................................................31Science Classification forms.....................................................................................31Personal Data form...................................................................................................31

Enclosures from ApplicantLetter from Collaborating Investigator (if applicable).........................................................................................32Letter from Consultant (if applicable).................................................................................................................32Reprints of Applicant’s Publications..........................................................................33

Submission of Your Application.........................................................................................33

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GENERAL INFORMATION

The American Heart Association has approved new peer review criteria for the fellowship programs. Make sure that you and your Sponsor are fully addressing the new peer review criteria given below.

Criterion #1 – EVALUATION OF THE INVESTIGATORAssessment of the applicant should account for 1/3 of the overall score.

1. Does the trainee have potential for a research career? 2. Are the trainee’s career plans specified in the application? 3. Is this supported by the trainee’s academic record and the assessment provided by

the 3 letters of reference? 4. Does the trainee have prior research experience and/or publications? 5. Is there a clear rationale supporting the need for the proposed training? 6. What is the sponsor’s assessment of the applicant?

Criterion #2 – SPONSOR/TRAINING PLAN AND ENVIRONMENTAssessment of the sponsor/training plan and environment should account for 1/3 of the overall score.

Sponsor/Training Plan1. Is the mentor an independent investigator? 2. Does the mentor have the experience to direct the proposed research training, as

evidenced by their track record regarding productivity, funding and prior trainees? 3. Does the mentor have adequate current funding to support the fellow’s project? 4. Does the mentor provide a comprehensive training plan that will facilitate the

applicant’s progress towards his/her research career goals? Environment 1. Does the scientific environment in which the work will be done contribute to the

probability of success for the training experience?2. Is there evidence of institutional commitment?

Criterion #3 – EVALUATION OF THE PROPOSALTogether, assessment of these three criteria should account for 1/3 of the overall Proposal score.

1. Significance : Does this study address an important problem broadly related to interventional cardiology? What will be the effect of these studies on the concepts, methods, and technologies that drive this field?

2. Approach : It is recognized that a new fellow may not have had adequate time to generate preliminary data. It is acceptable for applicants to present preliminary datagenerated by the sponsor. The assessment of preliminary data, whether generated by the sponsor or the applicant, should be put into perspective such that bold new ideas and risk taking on the part of the beginning investigators are encouraged rather than stymied.

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Are the conceptual framework, design, methods, and analyses adequately developed, well integrated, well reasoned, feasible (as determined by preliminary data or the expertise available in the mentor’s and/or collaborator’s laboratories) and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics?

3. Innovation : Is the project original?

Because the fellow receives primarily stipend support from these awards, additional research support for the proposed project MUST come from the Sponsor’s lab. Therefore, the proposed project will likely be related to the Sponsor’s funded research. The Sponsor should clarify the role that the applicant played in the development of the proposal, the relationship of the proposed project to ongoing research in the Sponsor’s laboratory, and how the project will contribute toward the training and career development of the applicant.

However, keep in mind that the submission of applications to AHA with identical or significantly similar content from a Sponsor (for project support) and a postdoctoral fellowship is prohibited. If submitted, the peer review committee will recommend a “disapproval” for both applications. If a grant application is submitted by a Sponsor of a fellowship application, both applications may be funded if there is no duplication of aims.

The AHA Research Committee approved the use of streamlined review (or “triage”) for all Association peer review groups. All programs (both fellowship and grant programs) are eligible for streamlined review. This process has been implemented to ensure that committee meeting discussion is focused upon applications that may be competitive. For applications that receive a streamlined review, applicants will receive critiques and notices without scores.

For assistance with program and eligibility criteria, instructions or form content contact:

Phone 212-878-5912, 5900Fax 212-878-5960E-mail aharesearch@heart.org

Print these Instructions and Forms -- You are advised to print these instructions for reference before completing your application. It is also recommended that you print all of the forms so you can see the pagination that you will need to maintain on your final application.

Only the items listed with an “X” on the Application Checklist (pages 8-10) should be completed. Refer to the Checklist for number of copies needed for all enclosures.

To complete the application form on your computer, you must have Word 3.0 for Windows (for PC) or a later version. If you have this capability, you should download the appropriate format to your computer’s hard drive from the web site in order to complete the application form. If you do not have this software capability or are having problems accessing the main application form, you may contact Mary Gonzalez at 212-878-5912 or aharesearch@heart.org and the necessary documents will be sent to you via email.

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Application Deadline -- Applications for this program must be submitted via email at: AHARESEARCH@HEART.ORG on later than Monday, March 16, 2009 at 5:00 p.m. Eastern Standard Time. Applicants are strongly advised to complete their required email submission early on the deadline day or preferably several days before, in case technical difficulties are encountered. Applicants who encounter technical difficulties with the email submission must contact the AHA office at the numbers above prior to the deadline (5:00 p.m. Eastern Standard Time) to resolve the situation. Otherwise, their applications will be rejected.

Email submission is mandatory. A complete submission requires forms and body of application in separate word document file(s) submitted to AHARESEARCH@HEART.ORG by the deadline. For instructions on how to submit via email go to our web site at http://www.americanheart.org/presenter.jhtml?identifier=3015642

Late applications will not be accepted.

You will receive an acknowledgment via the e-mail address provided. After submitting the application via email, the original with all signatures plus 3 paper sets must arrive at the Founders Affiliate NYC Research Office on Monday, March 23, 2009 by 5 p.m. Eastern Standard Time.

For instructions on how to assemble your paper copies, refer to page 11.

DO NOT MAKE ANY CHANGES TO YOUR PAPER COPIES AFTER THE EMAIL SUBMISSION. The application sent by email may be compared with the paper application; these applications must match word-for-word in the Project Summary and Proposed Research Plan. If changes to the text of the Project Summary or Proposed Research Plan occur, the application will be administratively withdrawn. If minor administrative changes are needed after email electronic submission (such as an incorrect zip code, budget miscalculations, incorrect administrative addresses, etc.), these changes must be addressed in writing by the Principal Investigator. The PI must notify the AHA in writing; send this letter to the same address given at the end of this document.

No supplementary material (additional preliminary data, new publications, etc.) will be accepted after the application deadline (with the exception of missing documentation requested by AHA staff).

Your application will be administratively withdrawn if you:

modify the Project Summary or Research Plan of the application after the email submission

submit the same or similar application for the fourth time fail to comply with format requirements (type size/characters per inch, lines per page, and

page limitations)

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An applicant may submit only one Affiliate application per deadline. An applicant may simultaneously submit applications for an Affiliate award and for a National award. If both are funded, the applicant must choose one award. An individual may not hold more than one Association award concurrently.

Applicants should never contact reviewers regarding their applications since discussion of the scientific content of an application or an attempt to influence review outcome will constitute a conflict of interest in the review. Reviewers are directed to notify the AHA if an applicant contacts them.

The timeline, from application submission to award activation, is given below for your information.

March 16, 2009 Email submission deadlineMarch 23, 2009 Paper deadlineApril, 2009 Applications assigned to peer review

committee and reviewersApril 2009 Applications sent to peer review committeeApril or May 2009 Peer review committee meetMay 2009 Founders Affiliate Research Committee meet

and determine funding levelsJune 2009 Awardees receive funding notificationsJuly 1, 2009 New awards activate

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TIPS FOR MARTIN B. LEON, MD, JOHNSON & JOHNSON CORDIS CORPORATION INTERVENTIONAL CARDIOLOGY FELLOWSHIP APPLICANTS

Before beginning an application, please review the specific award descriptions provided on the AHA local web site, (http://www.americanheart.org/presenter.jhtml?identifier=3015642) noting especially the qualifications and any restrictions for the program to which you will be applying.

To apply for the Martin B. Leon, MD, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship the following forms found on the AHA web site must be completed:

Main Form Sponsor Packet Reference Report for Applicant

Note: You will need to create some word-processed documents, and insert them into the Main Form or send them in separate word-processed documents. Also, a form is not provided for the Proposed Research Plan; refer to Instructions on pages 29-31 for Proposed Research Plan requirements.

Because the fellow receives primarily stipend support from these awards, additional research support for the proposed project MUST come from the Sponsor’s lab. Therefore, the proposed project will likely be related to the Sponsor’s funded research. The Sponsor should clarify the role that the applicant played in the development of the proposal, the relationship of the proposed project to ongoing research in the Sponsor’s laboratory, and how the project will contribute toward the training and career development of the applicant.

However, keep in mind that the submission of applications to AHA with identical or significantly similar content from a Sponsor (for project support) and a fellowship is prohibited. If submitted, the peer review committee will recommend a “disapproval” for both applications. If a grant application is submitted by a Sponsor of a fellowship application, both applications may be funded if there is no duplication of aims.

Reference Reports are critical to the Fellowship application. Check with your referents near the deadline to ensure that your Reference Reports have been sent to the American Heart Association. Reference Reports cannot be from your Sponsor.

The applicant and Sponsor should provide information regarding project funds available for the fellow. The absence of listed support indicates that the applicant has no funds available for research; it is expected that candidates applying for fellowships will receive support from their Sponsor or from institutional funds. A stipend for a fellowship cannot be awarded in the absence of adequate support for research expenses.

A Department Head letter is not part of a Fellowship application: the Sponsor’s information is critical for the application.

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Please refer to the Application Checklist below to determine which forms to complete and how to assemble your application.

MARTIN B. LEON, MD, JOHNSON & JOHNSON / CORDIS CORPORATION INTERVENTIONAL CARDIOLOGY FELLOWSHIP

APPLICATION CHECKLISTX = Required for program

The email submission and paper application should be assembled in the same sequence given below. Email submission includes all items listed under Body of Application including the Research and Science Classification Forms and Personal Data form.

The single-sided original application and each of the duplicated paper sets should be assembled in the sequence listed below. AHA prefers that sets be duplexed (printed on both sides of the sheet) but will accept single-sided sets.

Each set must be put in a manila folder. Items may be clipped or rubber banded. Do not staple. Mark the folder with the original application “original.”

BODY OF APPLICATION (original and 3 duplicated sets)

The body begins with form page 1 and ends with the Personal Data form.

Source Leon/Cordis

Project Summary, page 1 Main Form XProject Personnel/Signatures, page 2 Main Form XApplicant Information, page 3 Main Form XApplicant Information (continued), page 4 Main Form XAdministrative Information, page 5 Main Form XAdministrative Information (continued), page 6 Main Form XBiographical Sketch (PI) for applicant, pages 7 – 11(create Positions, Publications and Research Support section as PDF, number pages consecutively, and insert into main form; no more than 5 pages for the entire AHA Biographical Sketch)

Main Form- pg. 7Create Microsoft word processed documentpgs. 8-11

X

Co-Authors/References, number page consecutively following Biographical Sketch (PI)

Main Form X

Academic Record of Applicant (create as word processed document and insert following Co-Authors/References form)Insert pages into main form

Create Microsoft word processed document

X

Research Project Environment formFellowship applicants should leave blank this form page; the Sponsor Packet includes the Research Project Environment form

Leave Blank

Project Budget, number page consecutively following Academic Record of Applicant

Main Form X

Budget JustificationFellowship applicants should leave blank this form page and the Budget Justification Sample form.

Leave Blank

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BODY OF APPLICATION (continued) Source Leon/Cordis

Funds Available (1) form (by applicant), number pages consecutively following Project Budget. All applicants must complete a Funds Available form; type in “none” if you have no funds available. Delete other Funds Available forms (2-4) if not needed

Main Form X

Sponsor Packet - number consecutively following Funds Available (by applicant) pageIncludes Sponsor Information – Part I and Part II, Research Project Environment, andBiographical Sketch (Sponsor) Insert pages completed by Sponsor into main form. This form is not a part of the main form, but is located in a separate file at http://www.americanheart.org/presenter.jhtml?identifier= 3025391

Sponsor Packet Form

X

Co-Sponsor Packet (if Co-Sponsor designated) - number consecutively following Sponsor Packet formsIncludes Co-Sponsor Information – Part I and Part II, Research Project Environment, and Biographical Sketch (Co-Sponsor). Insert pages completed by Co-Sponsor into main form.This form is not a part of the main form, but is located in a separate file at http://www.americanheart.org/presenter.jhtml?identifier=3025393

Co-Sponsor Packetform

X

Proposed Research Plan (no more than 12 consecutively numbered pages), create as PDF and insert following Sponsor Packet as appropriate

Create Microsoft word processed document

X

Vertebrate Animal Subjects (to be addressed separately from the 12 pages of the Research Plan)Create as a word file at end of Proposed Research Plan

Create Microsoft word processed document

X

Literature Cited(no limit on number of literature references cited)Create as PDF at end of Proposed Research Plan (or at end of Vertebrate Animal Subjects if using animals)

Create Microsoft word processed document

X

Biographical Sketch for Collaborating Investigator(s)(Use NIH Biographical Sketch for Collaborating Investigators; number pages consecutively)Insert into main form

Create Microsoft word processed

document

X

Research Classification Forms (1,2)Do not delete this form from your electronic submission.

Main Form X

Science Classification Forms (1,2,3,4)Do not delete this form from your electronic submission.

Main Form X

Personal Data formDo not delete this form from your electronic submission.Exception: Do not submit any paper copies of this form; it should be submitted only in the electronic file.

Main Form X

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REQUIRED ENCLOSURES (to accompany mailed application)

Limited number of paper copies needed; number noted beside each item below.

Do not submit electronically. These items are to be submitted with your original and 3 paper copies. (See Assembly of Paper Sets.)

Leon/Cordis

Letter from Collaborating Investigator(s), if applicable (original and 3 copies) XLetter from Consultant(s), if applicable (original and 3 copies) X4 reprints each (or duplicated copies) of 3 pertinent (or most representative) publications by applicant (abstracts are acceptable for fellowship applicants)

X

4 copies of your American Heart Association Progress Report (if you currently hold or have held an AHA research award which has terminated within the past two years)

Note: The Reference Report for Applicant – Part I and Part II forms are in a separate file on the AHA web site (http://www.americanheart.org/presenter.jhtml?identifier=3025344). These should come from the referent directly to AHA. DO NOT INCLUDE THEM IN THE APPLICATION PACKAGE. The Reference Reports are considered confidential communications and will not be disclosed to the applicant.

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Assembly of Paper Sets

Assemble your paper copies in the following sequence, collating all materials into an original and 3 sets of like materials. Use staples, clips or rubber bands.

Top to bottom: Application (see Checklist for items included in Body of Application) Letter from each Collaborating Investigator, if applicable Letter from each Consultant, if applicable One each of 3 different reprints Copy of AHA Progress Report, if applicable

Original Set – in a manila folder labeled “original”

3 Duplicated Sets of Same Materials – each set placed in a manila folder

Do not include in original or sets:Personal Data formVisa documentationIRB or IACUC approvals

The following items should not be sent; if sent with paper sets, these pages will be counted toward the page limit, resulting in administrative withdrawal.

Enlarged or original set of images (photographs or color images of gels, micrographs, etc.)

Surveys, questionnaires, data collection instruments, clinical protocols, informed consent documents, etc.

Any additional printed materials not specifically requested in Instructions. The information will not be sent to reviewers.

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1 copy of each Reprint

1 copy of each Reprint

Original

ConsultantLetters(signed)

Original

ConsultantLetters(signed)

Original

Coll. Invest. Letters(signed)

Original

Coll. Invest. Letters(signed)

Original

Application (with original signatures)

Original

Application (with original signatures) 1 copy of

Progress Report (if

applicable)

1 copy of Progress Report (if

applicable) Cover Letter

(only if required by institution)

Cover Letter

(only if required by institution)

1 copy of each Reprint

1 copy of each Reprint

1 copy of

ConsultantLetters

1 copy of

ConsultantLetters

1 copy of

Coll. Invest. Letters

1 copy of

Coll. Invest. Letters

1 copy of

Application

1 copy of

Application

1 copy of Progress Report (if

applicable)

1 copy of Progress Report (if

applicable)

INSTRUCTIONS FOR PREPARINGMARTIN B. LEON/ JOHNSON & JOHNSON CORDIS CORPORATION

INTERVENTIONAL CARDIOLOGY FELLOWSHIP APPLICATIONS

Your application will be strengthened by the conciseness and clarity of its presentation. Page restrictions are noted throughout the instructions; these page restrictions must be observed by the applicant. If late or excessive in length, the application will be returned.

It is the responsibility of the applicant to make all necessary arrangements for conducting the proposed research work, both with the work institution and with the investigator (sponsor) under whom the work will be performed. A sponsor is the awardee's administrative link with the institution. The sponsor and the department head are responsible for determining the awardee's institutional rank and offering whatever supervisory or collaborative assistance is necessary for the progress of the awardee's research program. A sponsor must be familiar with an awardee's area of research.

Applications will be presented for review as received. Applications may not be modified after email submission.

The forms are password protected and default to a font style of Helvetica. Font size within the forms is controlled and cannot be altered by the applicant. For your research plan (and resubmission modifications and animal subjects text, if applicable) the following are AHA requirements:

no more than 15 characters per inch (cpi) or an average of no more than 15 cpi (cpi includes symbols, punctuation and spaces)

¾” margins should be used 60 lines per page are the maximum allowed (The average number of lines per page

using the font and point size below will be approximately 50-55 lines.) Windows Arial font style 12 point* Macintosh Helvetica 12 point *

*Figures, charts, tables, graphics and legends may be smaller in size but must be clear and legible.

It is essential that the text of your research plan complies exactly with the Association’s type specifications and page limits. Failure to comply will result in the administrative withdrawal of the application.

Users of other word processing programs must adjust settings appropriately and should measure text after saving. Type requirements should be checked using a standard measuring device (such as a ruler), rather than relying on the font selected for a particular word processing /printer combination . Type size specifications must be observed in the text of your research plan (and animal subject’s text, if applicable) or the application will not be reviewed and will be withdrawn.

Adherence to font and margin requirements is necessary. No applicant should have an advantage over other applicants by providing more content in his/her application by using smaller, denser type.

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The AHA has the responsibility to make the final determination of conformance to format requirements and the authority to withdraw applications. This decision is final and not subject to appeal.

BODY OF APPLICATION

The completed application must contain page numbers in sequential order. It is important that you add a footer containing the page number and name of the applicant to your word-processed document. It is advisable to first complete all of the required documents, insert page numbers and applicant’s name, and then insert into the main form.

PROJECT SUMMARY FORM

1. Type first name, middle name, last name, lineage, and degree(s).

2. Type in institution where research project will be performed.

3. Type name of Sponsor and degree(s).

4. Type name of Department Head and degree(s).

5. Affiliate name is already populated.

6. Award program is already populated. Leon/Johnson & Johnson Cordis Corp. Interventional Cardiology Award.

7. An applicant who is unsuccessful in a competition may resubmit the same or similar application three times (the original plus two resubmissions)*. If you are submitting a modified proposal to the AHA (whether it was submitted to National or an Affiliate previously), check Yes. If not, check No. If the “Yes” box is checked, the applicant must:a) Provide 1-2 pages of additional text which address modifications made to the

application due to suggestions/criticisms from the previous review;b) Display changes to the research plan in the revised proposal;c) Use the same project title as used for the original application, to facilitate tracking by

AHA.

If major changes are made to the application or if this is an entirely different/new project, it should not be checked as a resubmission.

(Resubmissions are not applicable to the Martin B. Leon, MD, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship Award)

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8. Founders Affiliate applications submitted for Martin B. Leon, Johnson & Johnson Cordis Corporation Interventional Cardiology Fellowship will be activated on July 1, 2009 and end on June 30, 2011.

9. Title may not exceed 100 letters and spaces; any titles exceeding this length will be automatically truncated and appear incomplete. Do not use abbreviations unless absolutely necessary.

10. The project summary should be a brief synopsis of the proposed project. The summary must be completed in the space provided. Include the following: a statement of specific aims the methods or techniques to be used, including the model to be used (animal,

tissue culture, etc.) the end points or objectives to be achieved

Note: You cannot enter special characters and formatting (such as super or subscripts, special characters, Greek symbols, italics, underlining, bolding, etc.) into this form field. This is a known limitation of Adobe Acrobat. You may enter text characters only in the Project Summary field.

11. These fields are read-only and cannot be completed. These fields will be automatically populated after completion of the Project Budget form.

PROJECT PERSONNEL/SIGNATURES FORM

1. List other personnel who will be involved with the research project in a significant role (i.e., will have impact on project content, data collection, data interpretation, etc.). Be certain to state name of institution if different from the Principal Investigator’s.

All personnel listed here must be classified based upon the following roles and definitions of roles in the project, regardless of whether a salary is requested. For each individual, select from the drop down list for the Role in Project. The Principal Investigator is not to be listed here, but the definition is given below for information.

Principal Investigator – the one person responsible to the applicant organization for the scientific and technical direction of the project (for the Fellowship program, this is the Leon, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship applicant)Note: The concept of Co-Principal Investigators is not recognized. The American Heart Association recognizes only one Principal Investigator. If two investigators are listed(each as Co-Principal Investigator), the first name listed will have primary responsibility for the project and the second name will automatically be listed as a Collaborating Investigator.

Sponsor – a senior investigator under whom the research project of a Leon, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship will be performed. A sponsor is the administrative link with the institution. The sponsor offers whatever supervisory or collaborative assistance is necessary for the progress of the research

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program. A sponsor must be familiar with an applicant’s area of research. (The Sponsor must complete a Sponsor Packet; see page 1, Table of Contents.)

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Co-Sponsor – a joint Sponsor of a Postdoctoral Fellowship applicant, having the same responsibilities described above for the Sponsor. Inclusion of a Co-Sponsor is considered an exceptional circumstance. (A Co-Sponsor must complete a Co-Sponsor Packet; see page 1, Table of Contents.)Note: In the case of fellowship awards, the services of a collaborator or consultant are not routine and should only be listed in cases where the collaborator or consultant is absolutely essential to the proposed research training experience. Please do not list all members of the department or all collaborators of your Sponsor. Also, it is a very unusual situation in which a fellowship applicant needs to include a technician on the project.

Collaborating Investigator – an individual who contributes in a substantive way to the scientific development or execution of the project; typically, these individuals have doctoral or other professional degrees; these individuals would devote a specific percent of effort to the project; by American Heart Association policy, a Collaborating Investigator may not be paid. (Each Collaborating Investigator must provide a letter; see page 2, Table of Contents.)

Consultant – an individual who contributes to the scientific development or execution of the project in a discrete way; typically, these individuals have doctoral or other professional degrees. Consultants may provide discrete services which are performed in a limited window of time or occasionally contribute a specific method/technique/analysis or materials for the project. (Each Consultant must provide a letter; see page 2, Table of Contents.)

2. Signatures required in this section are not expected for email submission. They are required on the original and paper copies only.

Type applicant’s name as used in signature. Applicant to sign original and date.

Type Sponsor’s name as used in signature. Sponsor to sign original and date.

Type Department Head’s name as used in signature. Department Head to sign original and date. If it is necessary for an acting Department Head to sign the application, indicate the name of the regular Department Head in order that future correspondence may be directed to the proper individual. (Not applicable to the Leon, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship)

Name the institution that will be financially responsible for the activities supported by the award.

Type Institutional Officer’s name as used in signature. Institutional Officer to sign original and date.

Note: The Association expects that an applicant will have institutional approval before submitting an application via email, just as he/she would if submitting via paper only. If the Grants Office/Sponsored Programs Office discovers minor administrative changes which are needed after the email submission occurs (such as an incorrect address, budget miscalculations, wrong Fiscal Officer’s name, etc.), these modifications should be submitted in writing by the Principal Investigator (and Grants Officer, if needed). It is the

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Association’s practice that applications are final upon submission; any modifications to the text of the Project Summary, Proposed Research Plan or animal subjects text (if

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applicable) are not allowed. A letter addressing minor administrative changes should be sent to AHA.

AssurancesThe applicant and institution are responsible for compliance with all American Heart Association research award policies and guidelines for the duration of any awards they may receive.

The institution assures that it is in compliance with current guidelines of the U.S. Department of Health and Human Services regarding recombinant DNA and Financial Conflict of Interest by the signature of the institutional official.

Go to Policies Governing All Research Awards to review AHA policies at http://www.americanheart.org/presenter.jhtml?identifier=12150

APPLICANT INFORMATION FORM

1. Type applicant’s name and degree(s). Enter doctoral degrees with no periods; e.g., MD, PhD, DVM, etc.

2. Type applicant’s e-mail address. Note: This e-mail address will be used to communicate with the applicant in several ways. You will receive information regarding funded status via this address. Due to the confidential nature of the award notification, please give an accurate e-mail address. If your e-mail address changes after submission of your application, notify the Founders Affiliate Research Office via e-mail at aharesearch@heart.org.

Address lines 3, 4, 6, and 7 cannot exceed 50 characters and spaces.

3. Self-explanatory.

4. Self-explanatory.

5. Type in name of institution where research project will be performed.

6,7. Use exact delivery address of institution, e.g., building and street number, P.O. box number, etc.

8. Self-explanatory.

9. Always use standard 2-letter abbreviation for the state. Provide at minimum your 5-digit zip code. Select country from drop-down list or type in name of country if not in drop-down list.

10. Type in contact numbers for applicant.

11-18. If institution where research will be performed is same as the current address, check box

and do not complete.

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If institution is different (such as Columbia University [current] and Albert Einstein College

19

of Medicine [where research will be performed] or a university [current] and a VA hospital [where research will be performed]) give work institution address in same sequence as current address. Or if you are currently at one institution and will be relocating to another, give the new address where work will be done.

Type in your institution’s name where research project will be performed.

Grants Office/Sponsored Programs Office should not be listed here. This address/location should be the physical location where the actual research will be conducted, if different from current address.

Type in contact numbers for applicant. Specify the effective date of this address.

19. Provide present title; e.g., postdoctoral fellow, graduate student, etc.

20. Enter your current academic position at time of application from drop-down list. (Items 19 and 20 may be the same.)

21. Provide anticipated title at time of award activation, July 1, 2008 (title may remain the same as in item 19).

22. Enter anticipated academic position at time of award activation from drop-down list (position may remain the same as in item 20).

23. Review the descriptions of career stage below and select most appropriate current career stage from drop-down list. These descriptions are requested for aggregate program evaluation purposes only.

Career Stage

Gaining CredentialsDoctoral candidatePhD, MD, MD/PhD, DO/PhD, or DVM/PhD or equivalent students

Attaining graduate credentials.

Directed StepPostdoctoral fellowPhD, MD/PhD or DO/PhD, MD, DO, DVM or equivalent

Building a career in research.

First Independent StepInstructor or other first academic appointment

Establishing independent status. Acquiring preliminary results as a basis for developing grant application.

Intermediate LevelAssistant professor or equivalentEntry not more than 8 years after PhD or subspecialty board eligibility (MD or DO)

Strengthening independent status. Acquiring new knowledge through research.

Recognized InvestigatorAssociate professor or equivalentProfessor or equivalent

Acquiring new knowledge through research. Establishing new research direction. Acquiring preliminary results as a basis for developing grant application.

Research Group LeaderProfessor or equivalent

Stimulating newly emerging areas of research. Strengthening research.

Other

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24. Give month and year of first faculty or equivalent staff appointment at an institution (such as Instructor; for these purposes, Postdoctoral Fellowships are not considered as first appointments). (June 2008 should be listed as 06/2008). Leave blank if not appropriate.

25. Type in month and year of first faculty/staff appointment at Assistant Professor (or equivalent) level. Leave blank if not appropriate.

26. Type name of degree with no periods. List the month and year for first doctoral degree. (June 2008 should be listed as 06/2008.)

27. Type in the specialty for your first doctoral degree that from the drop-down list. Enter the specialty that most closely coincides with your field of degree.

28 &29. If appropriate, complete additional doctoral degree information in same manner as items

26 and 27 above.

30. If you have not received a doctoral degree, complete.

31. Martin B. Leon, MD, Johnson & Johnson/Cordis Corporation Interventional Cardiology fellowship applicants should complete as of award activation date (July 1, 2009). If you have a medical degree, be sure to complete postdoctoral clinical training years and months.

32. Fellowship applicants should leave this item blank.

33. Check any of the awards that you have held or currently hold. Under “Other” list any other national funding agency/association award that you have held or currently hold. Specify agency and name of award.

34. If a United States citizen, type in United States. If you are not a U.S. citizen, type in the name of your country of citizenship.

35. Be very specific as to the immigration status you have. If you are not a U.S. citizen but currently in the U.S. with a visa, select the appropriate status from the drop-down list (such as F1). (U.S. citizens should leave blank.)

Applicants who have been lawfully admitted for permanent residence, i.e., are in possession of a Permanent Resident Card (formerly known as Alien Registration Card) or other legal verification of such status (such as I-551 stamp in passport), should choose Permanent Resident.

Applicants who have applied for permanent residency should choose Permanent Resident/Pending from the drop-down list. Only applicants who have filed form I-485 with the U.S. Citizenship and Immigration Services and who have received authorization to legally remain in the U.S. (having filed an Application for Employment form I-765) should choose Permanent Resident/Pending.

Awardees must meet AHA citizenship criteria throughout the duration of their awards.

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ADMINISTRATIVE INFORMATION FORM

1-10. Complete information for Sponsor.

11-19. Complete information for Grants/Sponsored Programs Officer. Type the institution

where research project will be performed.

20-24. Complete information for Fiscal Officer for institution that will be financially responsible for

the activities supported by the award. Type the institution where research project will be performed.

25. Indicate percent of applicant's total effort which will be devoted to this project. The time refers only to the period you expect to receive support from this award, not to any time which previously may have been spent on this project.

26. Total should equal 100%.

Effort to Research: Interventional Cardiology fellows will be expected to devote 25% FTE to research or activities directly related to their development into independent researchers, as opposed to administrative, patient care, or teaching responsibilities.

27. For this project: Check the appropriate blanks relating to experimentation.

(a) Self-explanatory.

(b) Self-explanatory.

(c) Human subjectsThe AHA has adopted just-in-time IRB/Privacy Board assurances for human subjects. Each applicant is strongly encouraged to submit his/her project to the appropriate human subjects Institutional Review Board/Privacy Board at the time of application. Funded applicants will have a maximum time of three months following the original activation date to submit the IRB human subjects approval and approved patient consent form for their projects to the AHA. (For example, if the activation date is July 1, IRB approval and approved patient consent form must be received prior to September 30.) If the IRB approval and approved patient consent form are not provided to the AHA within three months of the originally-posted activation date, the award must be relinquished; there are no exceptions.

Any significant change in the scientific research plan or scope/aims of the project subsequent to AHA submission must be reported to the AHA when submitting the just-in-time IRB/Privacy Board approval.

NOTE: If the proposed research project involves human subjects, the population sampled shall be inclusive of the general population, of relevance to the scientific

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question posed, without restriction in regard to gender, race, age, and socioeconomic status. Proposals that intentionally restrict the population sampled must include a compelling scientific rationale for such research design.

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(d) Adult human stem cellsThe American Heart Association funds human adult stem cell research. This research is governed by the standards described in “Ethical Aspects of Research with Human Subjects and Animals.” These standards shall be applied by the AHA in funding any research involving human adult stem cells. Applications involving human adult stem cells fall under the just-in-time IRB/Privacy Board assurance policy described above under human subjects.

(e) Human embryonic stem cells or fetal stem cellsIf your answer is “Yes”, you are not eligible to apply. Research applications involving the creation of human embryos or the derivation or use of human stem cells from in vitro fertilization (IVF) treatment embryos or fetal sources will not be accepted.

(f) Human fetal tissueThe AHA does not fund scientific research that involves the use of human fetal tissue.

(g) CloningThe AHA funds cloning research including human DNA sequences, cell lines and animals subject to ethical principles and restrictions to prevent abuse.

Acceptable researchAcceptable research involves cloning to generate animal models (such as transgenic animals) which express human disease for research use: to develop specific treatments for persons suffering from diseases, and to produce tissue or organs for transplantation to replace or augment damaged

or diseased tissues or organs in humans

Areas ineligible for AHA fundingCloning of humans as asexual reproduction or cloning of humans intended as sources of tissue or organs to harvest are not acceptable. However, the Association will fund research using human cell lines and DNA sequences for purposes of producing tissue or organs for transplantation to replace or augment damaged or diseased tissues or organs in humans.

(h) Animal subjectsIf your proposal involves animals and your institution does not have unqualified accreditation from the Association for Assessment and Accreditation of Laboratory Animal Care International (AAALAC) or does not hold a current Public Health Service (PHS) Animal Welfare Assurance, you are not eligible to apply.The AHA has adopted just-in-time IACUC assurances for animal subjects. Each applicant is strongly encouraged to submit his/her project to the appropriate animal care and use committee at the time of application; it is not a requirement that IACUC approval be deferred. Funded applicants will have a maximum time of three months following the original activation date to submit the IACUC approval for their projects to the AHA. (For example, if the activation date is July 1, IACUC approval must be received prior to September 30.) If the IACUC approval is not provided to the AHA

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within three months of the originally-posted activation date, the award must be relinquished; there are no exceptions.

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Any significant change in the scientific research plan and scope/aims of the project subsequent to AHA submission must be reported to the AHA when submitting the just-in-time IACUC approval.

(i) Self-explanatory.

(j) Self-explanatory.

BIOGRAPHICAL SKETCH (PI) FORM

To be completed by Principal Investigator (fellowship applicant).

Complete the AHA Biographical Sketch form page (which includes personal variances from ordinary career progression). This page is similar in format to the PHS 398 Biographical Sketch used by the NIH. Under Education/Training, begin with entry into college and include postdoctoral training. Under Variances from Ordinary Career Progression: Complete if applicable. Each award program has specific eligibility criteria or qualifications. Please review these qualifications or career stage requirements. If you have any extenuating circumstances that affect your eligibility for this particular program, please explain these circumstances. Explain personal variances from ordinary career progression (for example, child-rearing years, military service, unusual circumstances that led to gaps in research experience). It is incumbent upon the applicant to make a convincing justification of eligibility. Also, if you have had a name change (changed your name for any reason) and your name does not match the name on your publications, please address this briefly here. (For instance, your publication history reflects your maiden name and you have recently married and begun publishing under your married name.)

Next, if you have a current NIH Biographical Sketch you may insert it. Otherwise, create a Positions, Publications and Research Support section in your word processor and insert the word document after the Biographical Sketch form page. See the bottom of the Biographical Sketch (PI) form page for information to be included in these pages. For Peer-reviewed Publications, fellowship applicants should list all significant earlier publications even if they are not relevant to the proposed project (unless the page limit will be exceeded). Articles accepted for publication and abstracts may be listed. If you have no publications, under “Publications” indicate NONE.

Do not exceed 5 pages for the entire AHA Biographical Sketch.

CO-AUTHORS/REFERENCES FORM

Co-Authors

All applicants are to list all co-authors (at assistant professor level or above) with whom you have published an article or abstract within the past 3 years. If you cannot determine co-authors’ academic positions, list all co-authors within the past 3 years. If no publications, complete this area indicating NONE.

Current Supervisor

Give the name of your current, immediate Supervisor and his/her degree(s).

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REFERENCE REPORTS FOR APPLICANT FORM

This form is located in a separate file of additional required forms http://www.americanheart.org/presenter.jhtml?identifier=3025344

References

List names and addresses for three persons who have been requested to submit a Reference Report for Applicant (Part I and Part II). If possible select one referent who is not from your current department or organization. Reference Reports should be from individuals familiar with the applicant’s scientific interests and abilities (excluding Sponsor). Since reference reports are critical for your application, request reports only from individuals who will be able to return them by the application deadline date of March 16, 2009.

It is the responsibility of the Fellowship applicant to have 3 Reference Report for Applicant forms (Part I and Part II) sent to the American Heart Association. Duplicate the Reference Report for Applicant (Parts I and II), complete with applicant’s name, and provide to referents. Reference Reports may also be e-mailed by the applicant to referents for their completion and submission to the American Heart Association.

An electronic Reference Report is not required. The Reference Report may be typed on the form, typed on a separate letterhead and attached, etc.

If providing a paper copy to the referent, it is recommended that the applicant provide the respondent with a pre-addressed, postage-paid envelope for returning directly and confidentially to the address below. Reference Reports should not be faxed or e-mailed to the American Heart Association. Due to the confidentiality and the signature required, original Reference Reports must be received. Reference Reports should be received by March 16, 2009.

Three Reference Reports should be sent directly and confidentially to:American Heart Association, Founders AffiliateResearch Departmentattn: Mary Gonzalez122 East 42nd Street, 18th Floor.New York, NY 10168

Reference Reports are critical to your application. Check with your referents near the deadline to ensure that your Reference Reports have been sent to AHA. DO NOT INCLUDE REFERENCE REPORTS IN YOUR APPLICATION PACKAGE.

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Postdoctoral Fellowship Applicants

Please create the Academic Record as a new document using a blank page.

After creating this word-processed document, place applicant’s name in the lower right corner of each page. Insert this form after the Co-Authors/References form.

Note: If you received your education outside of the U.S., please provide this information as completely as possible. Translate the course names into English, if needed, and explain the grading or evaluation system.

Academic Record of Postdoctoral Applicant

Grade Point Average for Undergraduate Courses:

Explain grading system. Show level required for passing.

Grade Point Average for Graduate Courses:

Explain grading system. Show level required for passing.

State performance on Graduate Record Examination:

Give MCAT scores if appropriate:

Page ___ ___________________________Applicant’s Name

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RESEARCH PROJECT ENVIRONMENT FORM

The applicant should delete this form from the main application. This form is part of the Sponsor Packet, which is sent to the Sponsor to complete and is returned to the applicant for submission.

PROJECT BUDGET FORM

This page should be completed by all Fellowship applicants. Give costs to nearest dollar only.

Note: The totals will automatically calculate throughout the form.

An annual total which exceeds the maximum allowed for any year will be automatically adjusted by AHA staff.

Complete the Year 1 – Year 2 portion of the form at the top as appropriate.

1. Complete each year with salary and fringe benefits amount for the Principal Investigator.

Martin B. Leon, MD, Johnson & Johnson / Cordis Corporation Interventional Cardiology Fellowship stipend should be given here. If fringe benefits are allowed (such as health insurance, etc.), enter amount in fringe line.

2. Complete the total amount requested in each year for project support costs (see Project Support amount allowed in grid which follows).

3. The form will calculate subtotals on this line.4. No overhead or indirect costs are allowed for fellowships.5. The form will automatically calculate total costs. Once completed, these totals will

populate the Amounts Requested on the bottom of page 1, Project Summary page.

Summary of Information for Reference

Founders Affiliate

Stipend for Leon / Johnson & Johnson Cordis Corporation FellowFringe Benefits Allowed?Project Support Given?

Indirect/Overhead Costs?

2 years; $50,000 per year for PI stipend plus 15% of stipend ($7,500) for fringe benefits. Additional $17,500 per year for supplies and travel. Maximum annual amount not to exceed $75,000.

No indirect costs; no dependent allowances

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FUNDS AVAILABLE (1-4) - APPLICANT

Fellow Support (exclusive of funds available from Sponsor)

The Fellow should complete the Funds Available form only with currently active or pending fellowships. Include the Principal Investigator's (Fellow’s) name at the bottom right-hand side and number consecutively with the rest of the application. List all active fellowship awards first, then all pending fellowship awards (which have been submitted to any granting agency).

If you have applied to another agency for fellowship/training support and the period of support overlaps with that of this proposed American Heart Association fellowship, list that award status as Pending and check Yes, designating it as Alternative. Since this is considered an alternative proposal, the applicant can accept only one fellowship award if more than one is funded.If the fellow has no active or pending support in his/her own name, complete Funds Available (1) form and place None in item 1.

Delete Funds Available forms that are not needed.

1-8. Self-explanatory.

9. Type total award amount (total award dollars, stipend/project dollars/tuition and fees paid as part of award/institutional allowance that is part of award/training costs/etc., for all years of award).

10. Type total amount available to the applicant (all award dollars for all years of award.) This amount may be the same as item 9.

11. Type annual amount available to the applicant (minus salary and fringes). If annual amount is staggered, give an average annual amount. (For some awards that are stipend only, this might be $0.)

Examples for Items 9-11:

Example 1: Applicant is the recipient of a 3-year NRSA.

Item 9: Total award amount = $138,768 (stipend plus institutional allowance of $7,000 per year for supplies, equipment, travel to meetings and health insurance costs [considered a fringe benefit] x 3 years)Item 10: Total amount available to applicant = $138,768 (same as item 9)Item 11: Annual award amount available to applicant ($46,256 average annual amount) minus salary/fringes ($41, 256) = $5,000

Example 2: Applicant is the recipient of a 2-year fellowship from an institutional training grant.

Item 9: Total award amount = $0 (institutional total award amount is not required)Item 10: Total amount available to applicant = $70,000 ($35,000 x 2 years)Item 11: Annual award amount available to applicant ($35,000) minus salary/fringes ($31,000) = $4,000

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Procedural Policies and Standards

An application MUST be identified as ALTERNATIVE if submitted to more than one granting agency. Fellowship applicants must include information regarding Fellowship applications pending with any other granting agency.

After the application is reviewed by the Association the alternative designation of the project or the budget cannot be changed in order to accommodate any partial alternative funding.

The applicant can accept only one fellowship award if more than one is funded. An AHA fellowship awardee may hold only one named fellowship award.

SPONSOR PACKET

The complete Sponsor packet includes 3 items:1 - Sponsor Information - Part I and Part II2 - Research Project Environment3 - Biographical Sketch-Sponsor

The Sponsor must address all the areas covered by the Peer Review criteria (see pages 3-4) within the Sponsor Packet materials.

These forms are located in a separate file of additional required forms, named Sponsor Packet (http://www.americanheart.org/presenter.jhtml?identifier=3025391). The Sponsor Information, Research Project Environment, and a Biographical Sketch must be completed by the Sponsor, returned to the applicant and inserted into the application. The Sponsor may provide the information to the applicant in a word-processed format and the applicant may cut and paste the appropriate information into the forms and then insert them into the application.

The Sponsor Information, Research Project Environment, and Biographical Sketch are inserted in that order following the Funds Available (by applicant) and prior to the Proposed Research Plan.

Give or e-mail these forms to the Sponsor for completion. Also, give or e-mail the peer review criteria to your Sponsor and make sure that he/she is fully covering the criteria as part of the application and Sponsor Packet. Provide the Sponsor with a printed copy of this text in order to ensure proper completion of all forms.

1 - Sponsor Information – Part I and Part II

The Sponsor may add an additional one or two pages to each Part I and an additional three pages to Part II, if needed. The Sponsor should be certain to address all 7 items listed on the top of Part II. The Sponsor’s signature is required at the bottom of the original Part II (paper copy).

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2 - Research Project Environment

This page is similar in format to the PHS 398 Resources form used by the NIH. This allows the Sponsor to use information from a current Resources form already prepared for an NIH application. Information from the NIH Resources form can be copied and pasted into the Research Project Environment form. If a more extensive description is needed, one additional page may be added behind this form.

3 - Biographical Sketch (Sponsor)

Complete the AHA Biographical Sketch (Sponsor) form page. This page is similar in format to the PHS 398 Biographical Sketch used by the NIH. Under Education/Training, begin with entry into college and include postdoctoral training.

Next, if you have a current NIH Biographical Sketch you may insert it. Otherwise, create a Positions, Publications and Research Support section in your word processor, and insert it after the AHA Biographical Sketch (Sponsor) form page. See the bottom of the AHA Biographical Sketch (Sponsor) form page for information to be included in these pages. If you have no publications, under “Publications” indicate NONE.

Do not exceed 5 pages for the entire AHA Biographical Sketch.

CO-SPONSOR PACKET The inclusion of a Co-Sponsor is considered an exceptional circumstance.

The complete Co-Sponsor packet includes 3 items:1 - Co-Sponsor Information - Part I and Part II2 - Research Project Environment3 - Biographical Sketch-Co-SponsorThe Co-Sponsor must address all the areas covered by the Peer Review criteria (see pages 2) within the Co-Sponsor Packet materials.

If you have designated a Co-Sponsor, this individual must provide the Co-Sponsor packet. These forms are located in a separate file of additional required forms, named Co-Sponsor Packet (http://www.americanheart.org/presenter.jhtml?identifier=3025393). The Co-Sponsor Information, Research Project Environment, and a Biographical Sketch must be completed by the Co-Sponsor, returned to the applicant and inserted into the application. The Co-Sponsor may provide the information to the applicant in a word-processed format and the applicant may cut and paste the appropriate information into the forms and then insert them into the application.

The Co-Sponsor Information, Research Project Environment, and Biographical Sketch are inserted in that order following the Sponsor packet and prior to the Proposed Research Plan.

Give or e-mail these forms to the Co-Sponsor for completion. Also, give or e-mail the peer review criteria to your Co-Sponsor and make sure that he/she is fully covering the criteria as part of the application and Co-Sponsor Packet. Provide the Co-Sponsor with a printed copy of this text in order to ensure proper completion of all forms.

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1 - Co-Sponsor Information – Part I and Part II

The Co-Sponsor may add an additional one or two pages to each Part I and an additional three pages to Part II, if needed. The Co-Sponsor should be certain to address all 5 items listed on the top of Part II. The Co-Sponsor’s signature is required at the bottom of the original Part II (paper copy).

2 - Research Project Environment

This page is similar in format to the PHS 398 Resources form used by the NIH. This allows the Co-Sponsor to use information from a current Resources form already prepared for an NIH application. Information from the NIH Resources form can be copied and pasted into the Research Project Environment form. If a more extensive description is needed, one additional page may be added behind this form.

3 - Biographical Sketch (Co-Sponsor)

Complete the AHA Biographical Sketch (Co-Sponsor) form page. This page is similar in format to the PHS 398 Biographical Sketch used by the NIH. Under Education/Training, begin with entry into college and include postdoctoral training.

Next, if you have a current NIH Biographical Sketch you may insert it. Otherwise, create a Positions, Publications and Research Support section in your word processor and insert it after the AHA Biographical Sketch (Co-Sponsor) form page. See the bottom of the AHA Biographical Sketch (Co-Sponsor) form page for information to be included in these pages. If you have no publications, under “Publications” indicate NONE.

Do not exceed 5 pages for the entire AHA Biographical Sketch.

PROPOSED RESEARCH PLAN (no more than 12 pages; if page limit is exceeded, application will be administratively withdrawn)

A form is not provided for your proposed research plan.

For your research plan (and animal subjects sections, if applicable) the following are AHA requirements:

no more than 15 characters per inch (cpi) or an average of no more than 15 cpi (cpi includes symbols, punctuation and spaces)

¾” margins should be used 60 lines per page are the maximum allowed (The average number of lines per page

using the font and point size below will be approximately 50-55 lines.) Windows Arial font style 12 point* Macintosh Helvetica 12 point *

*Figures, charts, tables, graphics and legends may be smaller in size but must be clear and legible.

It is essential that the text of your research plan complies exactly with the Association’s type specifications and page limits. Failure to comply will result in the administrative withdrawal of the application.

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Word processing programs must adjust settings appropriately and should measure text after saving. Type requirements should be checked using a standard measuring device (such as a ruler), rather than relying on the font selected for a particular word processing/printer combination. Type size specifications must be observed in the text of your research plan or the application will be returned without review.

Create the Proposed Research Plan and after creating this word-processed document, number these pages consecutively; the applicant's name should appear in the lower right corner of each page. Insert the pages after the fellow’s Sponsor packet pages, as appropriate.

No more than 12 consecutively numbered pages (including any diagrams, tables, graphics/images, etc.) will be accepted. (Appendices or enlarged sets of images should not be sent; if sent with paper sets, these pages will be counted toward the 12-page limit, usually resulting in administrative withdrawal.) Applications with greater than 12 consecutive pages in the Proposed Research Plan (items 1-4 below) and/or not adhering to format requirements (characters per inch, etc.) will be administratively withdrawn.

Type the proposed research plan single-spaced, specifically following the outline given. All items should be addressed. Please indicate N/A or None if not applicable to this application.

The Research Plan should be written in such a way as to address all of the Peer Review criteria (see pages 3 for new criteria).

Suggested lengths are guidelines only but must not exceed 12 pages.

1) Specific Aims (1 page)

Provide a clear, concise summary of the aims of the work proposed and the hypothesis to be tested.

2) Background and Significance ( 3 pages)

Sketch briefly the background to the proposal; preliminary studies may be addressed here. State concisely the importance of the research described in this application by relating the specific aims to broad, long-term objectives.

State concisely the relevance of the research to cardiovascular function or disease, stroke, or to related fundamental problems.

3) Research Design and Methods (7-1/2 pages)

Provide the following information:a) research design and the procedures to be used to accomplish the specific aims;b) tentative sequence for the investigation;c) statistical procedures by which the data will be analyzed;d) discussion of potential experimental difficulties and alternative approaches to

achieve the aims

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Note: Except as provided below, if a proposed research project involves human subjects, the population sampled shall be inclusive of the general population, of relevance to the scientific question posed, without restriction in regard to gender, race, age, and socioeconomic status. Proposals that intentionally restrict the population sampled must include a compelling scientific rationale for such research design. Be sure to address this topic.

4) Ethical aspects of the proposed research (1/2 page)

Describe any special consideration you have given to all ethical issues involved in your proposed investigations (biohazards, human subjects, etc.), identifying risks and management. Be sure to address this topic. If using animals, see instructions below.

End of text (not to exceed 12 pages in the Proposed Research Plan).

VERTEBRATE ANIMAL SUBJECTS (to be addressed separately from the 12 pages of the research plan)

Format requirements are the same as those given for the Proposed Research Plan (characters per inch, font, etc.)

If using vertebrate animal subjects, address the following five points. In addition, when research involving vertebrate animals will take place at collaborating site(s) or other performance site(s), provide this information before discussing the five points.

1) Provide a detailed description of the proposed use of the animals in the work outlined in the Research Design and Methods section. Identify the species, strains, ages, sex, and numbers of animals to be used in the proposed work.

2) Justify the use of animals, the choice of species, and the numbers to be used. If animals are in short supply, costly, or to be used in large numbers, provide an additional rationale for their selection and numbers.

3) Provide information on the veterinary care of the animals involved.

4) Describe the procedures for ensuring that discomfort, distress, pain, and injury will be limited to that which is unavoidable in the conduct of scientifically sound research. Describe the use of analgesic, anesthetic, and tranquilizing drugs and/or comfortable restraining devices, where appropriate, to minimize discomfort, distress, pain, and injury.

5) Describe any method of euthanasia to be used and the reasons for its selection. State whether this method is consistent with the recommendations of the Panel on Euthanasia of the American Veterinary Medical Association. If not, present a justification for not following the recommendations.

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LITERATURE CITED

There is no page limitation. List all literature references. Each reference must list the authors in the same order as they appear on the paper, the title, the name of the book or journal, volume number, page numbers, and year of publication. References should be limited to relevant and current literature; be concise and select only those references pertinent to the proposed research.

BIOGRAPHICAL SKETCH (of Collaborating Investigator, if applicable)

AHA considers it highly unusual for a postdoctoral fellow to designate a Collaborating Investigator.

If you have a Collaborating Investigator, insert his/her NIH Biographical Sketch into your application. Provide a separate Biographical Sketch for each Collaborating Investigator named in your application.

A word-processed document should be created, saved and inserted into your application. The Collaborating Investigator’s Biographical Sketch should not exceed 5 pages.)

Insert and consecutively number these Biographical Sketches here.

RESEARCH CLASSIFICATION FORMS (1, 2)

Follow instructions on the form to categorize terms that best apply to your project.

SCIENCE CLASSIFICATION FORMS (1, 2, 3, 4)

Follow instructions on the form to identify scientific terms that best apply to your project.

PERSONAL DATA FORM

Review and complete if desired. (This is a confidential document and should not be included with each paper copy of the application.)

Provision of the 4-digits of the Social Security Number is voluntary. The American Heart Association requests it for the purpose of accurate identification and for efficient management of the Association’s research programs.

Please note: The Research Classification, Science Classification and Personal Data form are part of the email submission application. They are the last forms in the Main Form. Complete these forms based upon the instructions on the form.

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ENCLOSURES FROM APPLICANT(to be included with paper application materials

received one week after email submission deadline)

LETTER FROM COLLABORATING INVESTIGATOR (if applicable)

If a Collaborating Investigator is named on the Project Personnel/Signatures page, a letter must be provided confirming participation and amount of time to be devoted to the project.

The original letter and three copies should be provided.

LETTER FROM CONSULTANT (if applicable)

If a Consultant is named on the Project Personnel/Signatures page, a letter must be provided describing specific services for the project.

The original letter and three copies should be provided.

REPRINTS OF APPLICANT’S PUBLICATIONS

Submit 4 reprints each (or duplicated copies) of the 3 most pertinent publications by the applicant. (If none are considered pertinent to the project, submit 3 other publications which best represent your work.) Preprints and articles recently submitted may be used. Abstracts are acceptable for Fellowship applicants. (Publications which do not list the applicant as an author are unacceptable.)

FELLOWSHIP APPLICATION CHECKLIST

Refer to the Application Checklist at the beginning of these Instructions for appropriate number of copies needed and assembly of application.

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SUBMISSION OF APPLICATION

After submitting the application via email, the original and 3 duplicated sets are required.

The completed email application submission is due by March 16, 2009, 5 p.m. Eastern Standard Time. Submit your application via email to: AHARESEARCH@HEART.ORG. The original plus 3 paper sets must arrive at the New York City Research Office by 5 p.m. Eastern Standard Time, March 23, 2009 (one week later).

Mail materials to: American Heart Association, Founders Affiliate

Research Departmentattn: Mary Gonzalez122 East 42nd Street, 18th Floor.New York, NY 10168

For assistance with program and eligibility criteria, instructions or form content contact:Phone 212-878-5912, 5900E-mail aharesearch@heart.org

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