LymeNet - LDANJ Grant Information and Applicaton

LYME DISEASE ASSOCIATION of NEW JERSEY, INC.*
*Now has a Pennsylvania Chapter

PO BOX 1438 JACKSON, NEW JERSEY 08527
5019 MEGILL RD. FARMINGDALE, NJ
Lymeliter@aol.com
http://come.to/ldanj

Summer 1999

Dear Grant Applicant:

The Lyme Disease Association of New Jersey, Inc. (LDANJ) appreciates your interest and willingness to conduct research that could potentially lead to a cure for chronic Lyme disease. Currently, the LDANJ has funds available to award grants in varying amounts up to $25,000. Future grants could possibly be considered at a later date. Enclosed you will find a grant application for you to complete. Upon its receipt, the application and proposal information will be reviewed by a committee composed of physicians and LDANJ members. Certain projects will then be selected for consideration by the executive board of the LDANJ.

The LDANJ is an all-volunteer. non-profit, tax exempt corporation that has raised over $500,000 for Lyme research, prevention, and education. The most important objective of the LDANJ is to find a cure for chronic Lyme disease. Accomplishments include:
· Funding the Lyme Disease Research Project Fox Chase Cancer Center (PCR)
· Funding for Dr. Fallon, New York State Psychiatric Institute (brain scans)
· Funding the Lyme Disease Project University of Pennsylvania/VAMC (PCR)
· Funding Dr. Manfred Bayer, effects of low frequency radiation on B. burgdorferi
· Funding for Dr. Steven Schutzer, UMDNJ, gold standard test for active infection
· Funding for Drs. Liegner, Pavia, Niasi for hyperbaric oxygen study
· Funding for Norwalk Hospital HBO study
· Holding annual statewide seminars for educators
· Helping develop federal Lyme disease bill introduced in 1998 in House of Representatives
· Distributing information on Lyme disease to the general public
· Distributing "Patient Information Guide" to doctors
· Publishing "Tiny Tick Tales" informing readers of research updates and events
· Featuring TV Public Service Announcement on Lyme
· Producing low cost videos on Lyme disease
· Holding Lyme disease forum to educate federal officials

Please return 12 copies of the completed forms to the above Farmingdale address by September 17 , 1999. Deadlines will be strictly adhered to. Grants will be awarded by the end of 1999. No preliminary data is required to be awarded a grant. Any changes to your grant proposal need to be submitted in writing and are subject to the approval of the executive board of the LDANJ. If the research project needs to be continued over a period of time, future financial support win be reviewed and decided upon at the end of the funding period. If you have any questions or concerns, please direct them to Pat Smith, e-mail above, or Barbara Muniz, 732-255-2083.

Sincerely

Pat Smith
President

LYME DISEASE ASSOCIATION OF NEW JERSEY, INC.
GRANT APPLICATION FORM

PO Box 1438 Jackson, NJ 08527
5019 Megill Rd. Farmingdale, NJ 07727

PART I.Contact Person:
1. Name

Address

Telephone Number with area code(Day)

(Evening)

Fax Number

e-Mail address

2. Title of Research Project

3. Name of Principal Investigator

4. Name and address of institution where research will be conducted

5. Goals and objectives of the research pertaining to chronic Lyme disease

6. Timetable for the entire project

7. Timetable for the portion of the project to be funded

8. Annual cost of the project and the amount of funding requested

9. Other sources of funding and ways in which any financial shortfall will be funded

10. Discuss the following items on separate attachments:

A. Ways in which the project is consistent with the LDANJ's goals and objectives

B. Features that distinguish the project from similar projects (if known)

C. Method by which the project's effectiveness will be monitored and evaluated

D. If this research is part of an existing project, please explain

Page 2 Lyme Disease Association of New Jersey Grant Application Form
PART II.1. Please attach the following:

A. Description of qualifications of research personnel assigned to project

(Curriculum vitae and list of publications)

B. Detailed description of project, including the experimental design

C. Detailed budget

D. One paragraph summary of project to be released to the public by the LDANJ after grant award is announced

2. If your project is selected to receive a grant the researcher must agree to provide the following:

A. Project updates on a semiannual basis

B. A letter listing the goals of the project and general description of the experimental procedures used.

This letter must be on the official letterhead of the research institution, if applicable, and must be supplied to the LDANJ in numerous copies so it can be distributed for fund raising purposes. Copies of this letter need to be provided shortly after the project is approved for funding. If the project is continued over a series of years, similar letters must be provided in the first quarter of each year. These letters must contain a summary of what has been accomplished in the past year and what will be attempted in the upcoming year.

C. Budgets on an annual basis for continuing projects.

D. A detailed financial accounting of all money expended at the end of each monetary disbursement.

E. Permission for the LDANJ to distribute copies of any published articles resulting from the funded project.

F. Acknowledgment of LDANJ support must accompany any article resulting from the funded project.

G. At year and an annual project summary must be supplied on official letterhead of the

Research institution.

Page 3 Lyme Disease Association of New Jersey Grant Application Form

The executive board of the Lyme Disease Association of New Jersey, Inc. reserves the right to discontinue funding of the research project if the project does not meet the specifications submitted or if the information requested above is not supplied on time as agreed to in the grant application.

__________________________
Printed name of application

__________________________ _________________________
Signature of Grant Applicant Date