Eligibility

NMPRA Grants & Awards

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Each year, the National Med-Peds Residents’ Association (NMPRA) presents several grants and awards to exceptional residents & students across the country. Click on each title below to learn more about the distinction and how to apply.

o Must be a Med-Peds res ident physician in good standin g at the time ofapplication (with the exception of the Medical Student Case Competition)

o Must be a NMPRA member at the time of application• If not already a member, please go to medpeds.org to join

o Winners of the Onady, Schubiner, and Clinical Case Competition Awards must beable to attend the 2020 NMPRA National Conference

• Of note, this year’s meeting will be held in a virtual formato Winners of the Community Service, Advocacy, International Health Travel, QI

Project, and Research Grants must be available to present their activities andexperiences at the 2021 NMPRA National Conference

Deadline for submissions

September 11, 2020

The Gary Onady Award

The Howard Schubiner Award

Community Service Grant

Advocacy Grant

International Health Travel Grant

Quality Improvement Project Grant

Research Grant

Clinical Case Competition Awards

Outstanding Medical Student Interest Group Award

Winners 2O

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The Gary Onady Award Dr. Kathryn Nagel, Yale University

The Howard Schubiner Award

Dr. Valien Kondos, ChristianaCare Health System

Advocacy/Community Service Grant Drs. Sarah Soliman & Eric Zuniga, LAC+USC Medical Center

International Health Travel Grant

Dr. Abbie Rose Goodman, ECU/Vidant Medical Center

Quality Improvement Project Grant Dr. Rebecca Moore, Brown University

Research Grant

Dr. Austin Wesevich, Duke University

Resident Clinical Case Competition Award Dr. Ariel Nash, Albany Medical College

Medical Student Clinical Case Competition Award

Prarthana Patel, MSV, UMKC School of Medicine

Outstanding Medical Student Interest Group Award Brody School of Medicine at ECU

The Gary Onady Award

Submission Details

Named for Gary Onady, MD, PhD, this award honors his notable, extraordinary, and lasting impact on the Med-Peds specialty. It was created to recognize the significant contributions made by a Med-Peds resident physician to NMRPA and/or Med-Peds at the national or regional level. Dr. Onady completed a Bachelor of Science in Chemistry from the University of Cincinnati and completed his PhD training in Chemistry at the City University of New York in Bioinorganic/Physical Chemistry in 1982. That same year, he began Pharmacology fellowship training in pharmacodynamics, cytochrome P450, and antimalarial drug design at Case Western Reserve University School of Medicine. Dr. Onady continued with his clinical training, receiving an MD in 1987 at Wright State University School of Medicine and residency training in Internal Medicine–Pediatrics at MetroHealth Medical Center/Case Western Reserve.

Dr. Onady assumed the role of Program Director for the Med-Peds Residency Program at Wright State University. During this time, Dr. Onady became active at the local and national levels as he worked toward advancing the appreciation of the Med-Peds specialist. He has published numerous articles and editorials on Med-Peds and has served as both President of the Med-Peds Program Directors Association (MPPDA) and as their representative on the Primary Care Organizations Consortium. He has also volunteered his time as a faculty advisor to NMPRA.

Additional areas of interest include secondary health care for adult cystic fibrosis patients, for which Dr. Onady serves as the Adult Director of the Dayton CF Program; he also conducts research on the medical complications of cystic fibrosis and has overseen many workshops and presentations. He is also published on integrating evidenced-based medicine with clinical decision-making, and he actively integrates these concepts into both undergraduate and graduate medical education at Wright State University School of Medicine.

The winner of the Gary Onady Award receives $500 to be used for educational purposes. o You may either nominate yourself or request that your nominee’s Program

Director submit an application on his/her behalf. o The application must be submitted as a single PDF file and include all below:

• Nominee’s full name, program, and PGY level • Contact Information: Phone number, email address, Program Director’s

name and email address • Current curriculum vitae • Brief description of how you/nominee has contributed to the success of

Med-Peds at the national or regional level • Nominee must be a NMPRA member at the time of his/her application • Nominee must disclose all other financial sponsorships and donations

received • Nominee must be able to attend the NMPRA National Conference in the

year of application

Please email all completed applications to president-elect@medpeds.org.

The Howard Schubiner Award

Submission Details

Named for Howard Schubiner, MD, this award honors his notable, extraordinary, and lasting impact on the Med-Peds specialty. It was created to recognize the significant contributions made by a Med-Peds resident physician to NMRPA and/or Med-Peds at the local or state level. Dr. Schubiner completed a Bachelor of Arts degree from the University of Michigan. He received his MD in 1978 from Wayne State University. He completed a Pediatrics residency at Michigan State University and then finished his Internal Medicine residency at Wayne State University. Dr. Schubiner also has additional training in Adolescent Medicine. Dr. Schubiner has spent most of his career at Wayne State University. He developed a Med-Peds training program and was the Program Director at Wayne State University from 1984-1998. He has published numerous articles on Med-Peds and received many grants, in addition to serving as President of the Med-Peds Program Directors Association (MPPDA); he also helped found the American Academy of Pediatrics Section on Med-Peds. His special areas of interest are ADHD and adolescent health, one field at the developmental interface between Pediatrics and Internal Medicine and one in which both children and adults are affected in similar ways. The recipient of this award should be, in the words of Dr. Schubiner: “A resident who exemplifies the highest standards for excellence in Med-Peds, including exemplary clinical care of patients, compassion and humanism in relationships with patients and with colleagues in medicine and hospital co-workers, involvement in community activities, and contributions to the field of Med-Peds.”

The winner of the Howard Schubiner Award receives $500 to be used for educational purposes. o You may either nominate yourself or request that your nominee’s Program

Director submit an application on his/her behalf. o The application must be submitted as a single PDF file and include all below:

• Nominee’s full name, program, and PGY level • Contact information: Phone number, email address, Program Director’s

name and email address • Current curriculum vitae • Brief description of how you/nominee has contributed to the success of

Med-Peds at the local or state level • Nominee must be a NMPRA member at the time of his/her application • Nominee must disclose all other financial sponsorships and donations

received • Nominee must be able to attend the NMPRA National Conference in the

year of application

Please email all completed applications to president-elect@medpeds.org.

Community Service Grant

Submission Details

In 2007, NMPRA created the Advocacy/Community Service Grant. Since then, we have had exceptional annual participation from our members across the country, so much so that this year, we want to further expand the opportunity for involvement by separating this grant into two distinct awards. The Community Service Grant is intended to recognize Med-Peds resident physicians who actively engage in volunteerism within their communities, fostering a spirit of service and selflessness while promoting both generosity and a concern for the wellbeing of others, particularly the underserved and the marginalized. We are seeking applicants to design and implement a project that focuses on the needs of both children and adults in their communities. The recipient(s) will receive an award of $500 to be used toward the endeavor. Winners will be asked to present their project at the NMPRA National Conference in the year following submission and have their work featured in our quarterly newsletter, The Perspective, which is distributed nationally. The project will also be highlighted on the NMPRA website.

The application must be submitted as a single PDF file and include all below: o Your full name, program, and PGY level o Contact information: Phone number, email address, mailing address o Program Director’s name, email address, mailing address o Current curriculum vitae o Project title and description of proposed project in narrative format (less

than 200 words) o Project goals & objectives o Project budget (itemized) – please include whether you have received or

applied to any other sponsorships or grant monies o Describe your target population and community partners/sponsors o Include a proposed timeline to complete your project o List potential barriers to completing your project or barriers in your

community. How do you plan to overcome these barriers? o How do you plan to sustain and implement your project? o How do you plan to assess the progress and achievement of your project? o Letters of recommendation from your Program Director and faculty sponsor

Please email all completed applications to president-elect@medpeds.org.

Advocacy Grant

Submission Details

In 2007, NMPRA created the Advocacy/Community Service Grant. Since then, we have had exceptional annual participation from our members across the country, so much so that this year, we want to further expand the opportunity for involvement by separating this grant into two distinct awards. The Advocacy Grant is intended to recognize Med-Peds resident physicians who actively champion for the rights of their patients and fellow healthcare providers within their local and/or national communities. Their work should focus on non-partisan activities intended to impact public policy, laws, and/or budgets in the health care arena. In doing so, they should seek to educate both lawmakers and the public as well as encourage both civic engagement and collective action in an effort to promote quality, accessible, safe, and patient-centered care. NMPRA is seeking applicants to design and implement a project that focuses on advocating on behalf of both children and adults in their communities. The recipient(s) will receive an award of $500 to be used toward the endeavor. Winners will be asked to present their project at the NMPRA National Conference in the year following submission and have their work featured in our quarterly newsletter, The Perspective, which is distributed nationally. The project will also be highlighted on the NMPRA website.

The application must be submitted as a single PDF file and include all below: o Your full name, program, and PGY level o Contact information: Phone number, email address, mailing address o Program Director’s name, email address, mailing address o Current curriculum vitae o Project title and description of proposed project in narrative format (less

than 200 words) o Project goals & objectives o Project budget (itemized) – please include whether you have received or

applied to any other sponsorships or grant monies o Describe your target population and any partners/sponsors o Include a proposed timeline to complete your project o List potential barriers to completing your project. How do you plan to

overcome these barriers? o How do you plan to sustain and implement your project? o How do you plan to assess the progress and achievement of your project? o Letters of recommendation from your Program Director and faculty sponsor

Please email all completed applications to president-elect@medpeds.org.

International Health Travel Grant

Submission Details

NMPRA has always encouraged international electives as a way to broaden one’s education and clinical skills. Since 2010, we have awarded the International Health Travel Grant to encourage the pursuit of global health initiatives among our members. This year, we will award $500 to a Med-Peds resident physician planning to complete a clinical Internal Medicine or Pediatrics elective in the developing world during residency. The NMPRA Board of Directors will serve as the selection committee for this grant. Grant requirements:

o The elective should be at least 4 weeks in length and primarily clinical in nature.

o Applicant must be a resident physician in good standing and a NMPRA member at the time of application.

o Applicant must submit his/her application prior to departure. o Applicant must develop a list of written objectives prior to departure. o Applicant must identify a preceptor in the host country. o Upon return home, grant recipient must submit a written summary of his/her

experiences to the NMPRA Board of Directors and be prepared to present at the following year’s NMPRA National Conference.

o Post-residency training fellows and previous recipients are not eligible to apply.

Please do not apply for this grant if you are being paid for this rotation in addition to your regular resident salary. However, you may seek other sources of funding for your rotation in addition to this grant.

The application must be submitted as a single PDF file and include all below: o Your full name, program, and PGY level o Contact information: Phone number, email address, Program Director’s

name and email address o Current curriculum vitae o Country of destination, name and position of preceptor in host country o List and describe your objectives for the project o Letter of recommendation from your Program Director

Please email all completed applications to president-elect@medpeds.org.

Quality Improvement Project Grant

Submission Details

One grant of up to $150 will be awarded annually to a Med-Peds resident physician who is seeking to contribute to the ever-growing field of quality improvement at his/her home institution. Winners will be asked to present their project at the NMPRA National Conference in the year following submission and will have their work featured in NMPRA’s quarterly newsletter, The Perspective, which is distributed nationally. The project will also be highlighted on the NMPRA website.

The application must be submitted as a single PDF file and include all below: o Your full name, program, and PGY level o Contact information: Phone number, email address, mailing address o Faculty sponsor’s name, email address, mailing address o Current curriculum vitae o Project title and description of proposed project (less than 200 words) o Project goals & objectives o Project budget (itemized) – please include whether you have received or

applied to any other sponsorships or grant monies o Include a proposed timeline to complete your project o How do you plan to assess the progress and achievement of your project? o Letter of recommendation from your faculty sponsor

Please email all completed applications to president-elect@medpeds.org.

Research Grant

The NMPRA Research Grant funds clinical, resident physician-led Med-Peds research projects. Our goal is to provide pilot research funding to promising and innovative projects at a time in training when securing substantial monetary support can be challenging. Although the scope of funded research is broad, we seek to support projects that aim to impact and improve patient care. Areas of research can include, but are not limited to: clinical research, health services or outcomes research, public health, epidemiology, informatics, and other general Med-Peds clinical research domains. Quality improvement projects without rigorous research methodologies will not be considered. We will award up to $2,500 per selected project. The number of grants will depend on the funds available and the amount of funding requested by each selected project. Grant requirements:

o The principal investigator (PI) of any proposal submitted must be a resident member of NMPRA or have submitted an application for membership.

o Eligible applicants are defined as: 1) Med-Peds resident physicians in good standing or 2) Med-Peds chief resident physicians (“5th year chiefs”)

o Proposals submitted should address an important area of concern for the health or healthcare of children, adolescents, and adults, preferably one particularly salient to Med-Peds.

o Awards are one-time awards; multiple-year funding requests will not be considered. Preference will be given to those proposals with the potential for large-scale or long-term success and which address important Med-Peds health issues.

Applications – each proposal must include the following items:

o Cover Page – project title, PI name and contact information (address, telephone, email address), level of training and program, primary mentor name and contact information, Division Director, and Department Chairs.

• Click here for a template o Budget and Budget Justification – do not include overhead (indirect costs), salary

for the PI or mentors, or equipment for long-term use (e.g., computers, iPads, phones, etc.). A maximum of $500 is allowable for travel to the NMPRA National Conference during which you will be required to present the results of your research as a condition of receiving this grant. You may request up to a total of $2,500. All items must be justified, and the Board may modify your final budget if required. Proposals only requesting funds for publication fees after research has already been completed will not be considered.

• Click here for a template o Description of the Proposal – include specific aims, background, preliminary studies

(if applicable), detailed methods, evaluation plan, timeline (must be completed within 1 year), description of key personnel, significance, tables (if any), and appendices (if any). This cannot be more than 8 double-spaced pages with 1” margins. You must use a font size no smaller than Arial 11. The cover page, references, tables/appendices, and budget are not included in the 8-page limit.

o Relevance to Professional Career – describe why you selected this topic for study and how this proposed project fits into your career plans. Include relevant research, clinical experience, and how the knowledge and skills you will learn can contribute to your future professional goals.

o Biographical Sketch – use the standard NIH Biosketch form. For this purpose, the Biosketch is not to exceed 2 pages. It does not count toward the page limit.

• The form can be found here: http://grants.nih.gov/grants/funding/phs398/biosketch.doc

• Instructions for filling out the form can be found here: http://grants.nih.gov/grants/funding/phs398/biosketchsample.doc

Submission Details

o Letter of Support – from your primary research mentor. Include your mentor’s NIH Biosketch (not to exceed 4 pages) and the plan for communication with the mentee. It does not count toward the page limit.

• The research mentor must have relevant research background and be knowledgeable in the specific field related to the project. The mentor’s Biosketch should include a list of his/her research funding. The mentor’s letter of support should explicitly answer the following questions:

§ How does the proposed project fit into the resident’s career plans? § How was the topic selected by the resident? § What components of the proposed study will the resident perform

directly? § What is the resident expected to learn from conducting the

proposed research? § Is the proposed project feasible to complete during residency

training (e.g., elective time set aside during the residency to complete the project)?

§ What exactly is the mentor committed to do to ensure that the resident increases his/her research skills and successfully conducts the project?

o Letter from Residency Program Director – must indicate that you are in good standing with your residency program. The PD must write a letter of support and commitment which outlines the time available for the resident to conduct the research project, such as research electives, etc. It does not count toward the page limit.

The NMPRA Board of Directors will review and vote on all submitted applications. Review criteria for proposals include: relevance of the proposed project to Med-Peds, likelihood of project success, support from the home institution as well as commitment of the research mentor, and overall quality of the submission. Grants will be awarded with the understanding that the project must be initiated by October of the year of submission and will be completed within one year. Winners are encouraged to submit abstracts from their projects to other national research meetings. However, you must include an acknowledgement of grant funding from NMPRA for any abstracts, poster presentations, and manuscripts that result from this research project. Winners are required to submit to the NMPRA Board of Directors a progress report on the funded project 9 months after the project start date and a final report upon completion of the project. Winners are also required to attend the NMPRA National Conference in the year after grant reception to present the results of their research.

o Email all completed applications as a single PDF file to president-elect@medpeds.org • Letters from the Program Director and primary research mentor as well as their

Biosketches may be emailed separately o Submit your proposal to your Institutional Review Board (IRB) as soon as possible. No

checks will be awarded without prior IRB approval or exemption. Funds must be used only for allowed expenses detailed in the final budget approved by the Board for the approved project only. Any changes must be submitted for approval.

o Always notify NMPRA of any address or contact information changes.

Please adhere strictly to the above requirements – failure to do so will prevent your application from being considered for funding.

Clinical Case Competition Awards

Submission Details

NMPRA invites all of its members to submit novel and interesting Med-Peds clinical cases for our annual Med-Peds Clinical Case Competition. We welcome cases submitted by both resident physicians and medical students. Cases should be interesting clinical presentations pertinent to Internal Medicine or Pediatrics and should also display significant educational value for a Med-Peds audience. Cases may not have been presented previously at regional or national levels. However, those who have presented locally may still submit their abstracts for consideration. Each resident physician and medical students may submit only one case for the competition. Winning abstracts will have the opportunity to present their case at our NMPRA National Conference in the year of submission. Each speaker will have 10-15 minutes dedicated to their case.

The application must be submitted as a single PDF file and include all below: o Your full name, program/school, PGY/MS level o Contact Information: Phone number, email address o Program Director’s (or faculty sponsor for students) name and email

address o Title of the case o Brief abstract including clinical case presentation and discussion. Your

total abstract should not exceed 2200 characters (not including spaces). Abstracts will be reviewed by members of the NMPRA Board of Directors to determine the winners. Submissions exceeding the 2200-character limit will not be considered.

Please email all completed applications to president-elect@medpeds.org.

Outstanding Medical Student Interest Group Award

Submission Details

Each year, the NMPRA Board of Directors awards $300 and showcases one outstanding Med-Peds medical student interest group whose activities in the preceding year best exemplify our organization’s mission to enhance the Med-Peds specialty by:

o Supporting and promoting member advancement and professional opportunities

o Creating national connections and opportunities o Increasing awareness of and advocating for Med-Peds as a

specialty o Recruiting medical students to the specialty

Student groups can distinguish themselves by demonstrating commitment to promoting the specialty of Med-Peds, recruiting new medical student members, serving their communities, and/or collaborating with Med-Peds residency groups.

Register your group with NMPRA using the online form at medpeds.org (located under the Get Involved! tab) or by emailing info@medpeds.org. The application must be submitted as a single PDF file and include all below:

o A written statement in 500 words or less explaining how your group has distinguished themselves in the areas listed above.

o One letter of recommendation from a faculty mentor or school official who can attest to your group’s contributions.

Though not required, please submit any photos you may have of your group participating in these activities.

Please email all completed applications to president-elect@medpeds.org.

Past Award Recipients

The Gary Onady Award 2019: Dr. Kathryn Nagel, Yale University 2018: Dr. Joshua Price, UMMS-Baystate 2017: Dr. Robin Felker, University of Massachusetts 2016: Dr. Brandon Allport, University of Miami 2015: Dr. Eric Chow, Brown University 2014: Dr. Himani Divatia, ChristianaCare Health System 2013: Dr. Brandon Abbott, SUNY Buffalo 2012: Dr. Thomas Heyne, Massachusetts General Hospital 2011: Dr. Jen McEntee, University of North Carolina 2010: Dr. Jessica Wilson, Medical College of Wisconsin 2009: Dr. Arlene Chung, East Carolina University 2008: Dr. Kenneth Remy, Case Medical Center 2007: Dr. Ranya Sweiss, University of Michigan 2005: Dr. Emery Chang, Tulane University 2004: Dr. David Kendrick, Tulane University 2003: Dr. David Kaelber, Brown University 2002 2001: Dr. Brian Zimmerman, Wright State University 2000: Dr. Heath Parker, Texas A&M University The Howard Schubiner Award 2019: Dr. Valien Kondos, ChristianaCare Health System 2018: Dr. Michael Maguire, ChristianaCare Health System 2017: Dr. Christopher Terry, Brown University 2016: Dr. Amrit Misra, Wayne State University 2015: Dr. Olatonkunbo Famakinwa, Yale University 2014: Dr. Pritesh Gandhi, Tulane University 2013: Dr. Katherine Seymour, Vanderbilt University 2012: Dr. Loren Robinson, University of North Carolina 2011: Dr. Sonia Malhortra, Tulane University 2010: Dr. Jennifer LeComte, ChristianaCare Health System 2009: Dr. Jennifer Packard, ChristianaCare Health System 2008: Dr. Jennifer Genuardi, ChristianaCare Health System 2007: Dr. Stephanie Zia, University of Southern California 2005: Dr. Eric Gustafson, Tulane University 2004: Dr. Phyllis Nsiah-Kumi, Case Western Reserve 2003 2002 2001: Dr. Shana Hart, Louisiana State University 2000: Dr. Will iam F. Grella, St. Joseph’s Hospital 1999: Dr. Jeffrey Bates, Texas A&M University Advocacy/Community Service Grant 2019: Drs. Sarah Soliman & Eric Zuniga, LAC+USC Medical Center 2018: Dr. Sarah Himmelfarb, Tulane University 2017: Dr. Eric Chow, Brown University 2016: Dr. Kira Watson, LAC+USC Medical Center 2015: Drs. Amelia Averyt & Roma Moza, Baylor University 2014: Dr. Carolyn Bramante, Johns Hopkins University 2013 2012: Drs. Kingal Changela & Colleen Keough, Baylor University 2011: Dr. Caroline Presley, Vanderbilt University 2010: Dr. Sima Pendharkar, Duke University 2009: Dr. Sylvia LaCourse, Brown University Quality Improvement Project Grant 2019: Dr. Rebecca Moore, Brown University 2018: Dr. Pooja Jaeel, UC San Diego

International Health Travel Grant 2019: Dr. Abbie Rose Goodman, ECU/Vidant Medical Center 2018: Dr. Ashley Cobb, University of Michigan 2017: Dr. David Flood, University of Minnesota 2016: Dr. Shalini Vaid, University of Rochester 2015: Dr. Karina Zaveri-Whelan, University of Michigan 2014: Dr. Alexandra Wright, Louisiana State University 2013: Dr. Adnan Mustafa, University of North Carolina 2012: Dr. Emily Fisher, Medical College of Wisconsin 2011: Dr. Karla Testa, ChristianaCare Health System 2010: Dr. Paul Krezanoski, Massachusetts General Hospital Research Grant 2019: Dr. Austin Wesevich, Duke University 2018: Dr. Nicole Herrick, UC San Diego 2017: Dr. Robin Ortiz, Johns Hopkins University 2016: Dr. Eric Chow, Brown University 2015: Dr. Laura Flannery, Massachusetts General Hospital 2014: Dr. Dina Hafez, University of Michigan Resident Clinical Case Competition Award 2019: Dr. Ariel Nash, Albany Medical College 2018: Dr. Bryan Haimes, ChristianaCare Health System & Dr. Jessica Jaddaoui, Albany Medical College 2017: Dr. Michelle El-Hosni, Detroit Medical Center/Wayne State University 2016: Dr. Mara Horwitz, University of Missouri-Kansas City 2015: Dr. Elizabeth Petersen, Brigham and Women’s/Boston Children’s & Dr. Ken Visalli, University of South Florida 2014: Dr. Timothy Menza, Brigham and Women’s/Boston Children’s Dr. Suma Chennubhotla, University of Louisville Dr. Vidya B. Pai, University of Arkansas Dr. Elimarys Perez-Colon, University of South Florida Dr. Andrew Nickels, University of Chicago Dr. Heath Wilt, University of Missouri-Kansas City Dr. Agnes Sundaresan, Geisinger Medical Center Dr. Marcus Carden, Virginia Commonwealth University Medical Student Clinical Case Competition Award 2019: Prarthana Patel, MSV, UMKC School of Medicine 2018: Mackenzie Naert, MS4, Icahn School of Medicine at Mount Sinai 2017: Selena Marie-Rodriguez, MS4, University of Puerto Rico School of Medicine 2016: Sam Wainwright, MS4, University of Il l inois at Chicago 2015: Matt Erlich, MS4, Brown University & Emily Cordes, MS4, Michigan State University COM Outstanding Medical Student Interest Group Award 2019: Brody School of Medicine at ECU 2018: Northeast Ohio Medical University 2017: Icahn School of Medicine at Mount Sinai

NMPRA RESEARCH GRANT COVER PAGE

Project Title

PI Name PI Contact Info (institution, mailing address, phone, email)

PI Level of Training and Institution PGY:

Institution:

Primary Mentor Name Primary Mentor Email

Division (or Program Director for Med-Peds Residency) Director Name

Division (or Program) Director Email

Department Chairs Names Department Chairs Emails

Proposals involving human subjects require Institutional Review Board (IRB) approval. Has your IRB approved this proposal?

YES

NO

Currently Under Review

Not Applicable (no human

subjects)

The check will be made payable to the name of the institution. The grant must be used specifically for this project and not any others. Funds from grant award should not be used for computer or electronic equipment. No indirect charges will be paid to the institution. Please issue the check to: Institution Name Institution Address Institution Telephone

*Participation Statement If funded, I agree to attend and present my research results at the NMPRA National Conference in Fall 2021. Signature of Applicant _____________________________________

Sample Budget Note: Sample items are listed. However, this is not an exhaustive list.

Item Justification Amount Research Assistant (rate/hour * number of hours OR percent effort * duration; tasks) $XXXX Equipment* (not computer, but project-specific such as digital recorder for qualitative data collection) XXX Transcription (rate * time * number of subjects) XXX Remuneration (amount/subject * number of subjects) XXX Postage (amount/mailing * number of mailings) XXX Software, type (number of licenses) XXX Supplies (specify items and amount for each itemized) XXX Consultant, name (time and role) XXX Local travel (miles/trip * number of trips * Fed rate) XXX NMPRA National Conference Travel for October 2021 (max $500) XXX Research training*** (specific course, dates, location) XXX TOTAL $XXXX