2023 NKF Health Equity
Community Engagement Award 

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***STOP!***

Only use this form to start a NEW application.

If you've already started an application, use the link in the top right-hand corner to resume your application. Click "Next Page" to find and resume where you left off.



Welcome!

Please review the Instructions to Applicants for National Kidney Foundation Health Equity Grants before completing this application.


All applications and supplementary materials are due by February 13, 2023.

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Applicant Information








Project Information

Please do not exceed 255 characters, including spaces.



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About Applicant



Present Mailing Address







Permanent Mailing Address






Phone and Fax




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Sponsoring Institution










Other Personnel

Documentation of Collaborative Arrangements

Upload letters from consultants/partners indicating their willingness to assist in the pursuit of this project and any conditions on such assistance, if applicable. e.g. community-based partner who will be available to consult with regard to evaluation of data collected.

*All uploaded files must be in either PDF or Microsoft Word format


Click on the "Choose Files" button to find the appropriate file(s) on your computer. Clicking "Open" will upload the file(s). Your file will be automatically uploaded.











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Assurances

(Upload copies of relevant documents below.



Signatures
The indivuduals signing below attest that:

  • Research funded pursuant to this application will be conducted as described herein
  • Institutional resources will be made available, as specified, to pursue this investigation. They agree to follow the terms and comply with the policies for the research funding mechanism for which funding is sought.
Note: By signing this application electronically, I certify the information provided is accurate. I understand that an electronic signature has the same effect and can be enforced in the same way as a written signature.


Name of Fiscal Officer:



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Research Proposal  

Attach pages describing research proposal in the format described in the respective Instructions to Applicants.

Please observe the page limitations for each section of the research proposal as described in the Instructions to Applicants.

*All uploaded files must be in either PDF or Microsoft Word format


Letters of Support (Optional)


Attach three (3) letter of recommendation from health partners, supervisors, etc.

*All uploaded files must be in either PDF or Microsoft Word format




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Applicant Biosketch
Applicant's Employment/Training

(after college) in chronological order
Activity/Occupation 1

From:


To:





Activity/Occupation 2

From:


To:





Activity/Occupation 3

From:


To:





Prior or Current Research Support

Academic and Professional Honors

Applications for Concurrent Support

List all pending support (training, research, supplies, travel, etc.) that would run concurrently with the period covered by this application whether or not you are the Principal Investigator. Include the type, date, source and amount.
Pending Support 1





Pending Support 2





Pending Support 3





Pending Support 4





Pending Support 5







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Research Experience



%

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Signatures

Note: By signing this application electronically, I certify the information provided is accurate. I understand that an electronic signature has the same effect and can be enforced in the same way as a written signature.