Registration Form (Intent to Apply)
Lung Health Foundation (LHF) Breathing as One (BaO) Awards 2021-2022

Deadline: Monday February 15, 2021 by 4:00pm EST
If you require any assistance in filling out this form, please contact Natalie Bennett at nbennett@lunghealth.ca.

1. Basic Information

Question Title

* a) Applicant

Name

Institution and Department

Position

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

2. List the members that are a part of your research team

Question Title

* a) Principal Investigator (if different than applicant)

Name

Institution and Department

Position

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* b) Co-Principal Investigator (if applicable)

Name

Institution and Department

Position

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* c) List the co-applicants (if applicable) in Firstname Lastname, Institution order separated by semi-colons (e.g. Natalie Bennett, Lung Health Foundation; John Snow, University of Toronto; etc):

Question Title

* 3. What type of award are you applying for?

Breathing as One (BaO) – Breathing Breakthrough Challenge Award

Breathing as One (BaO) – Kayla Baker Lung Health Foundation Staff & Volunteer Pediatric Research Award

Breathing as One (BaO) – Non-Small Cell Lung Cancer Research Award

Breathing as One (BaO) – Young Investigators Research Award

Breathing as One (BaO) – Health Disciplines Training Bursary Award

Question Title

* 4. Location where the research will be carried out and appointment held:

University or Institution

Department

Address

City

Province

Postal Code

Question Title

* 5. Title of the proposed research project:

Question Title

* 6. Provide an abstract or essay describing how the funding will be used/purpose of the research (approx 500 words):

Question Title

* 7. List five key words which identify the project:

Question Title

* 8. Upload a “Letter of Nomination” (LHF BaO Young Investigators Research award ONLY)

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Choose File

Registration Form (Intent to Apply) Lung Health Foundation (LHF) Breathing as One (BaO) Awards 2021-2022

Question Title

* a) Applicant

Question Title

* a) Principal Investigator (if different than applicant)

Question Title

* b) Co-Principal Investigator (if applicable)

Question Title

* c) List the co-applicants (if applicable) in Firstname Lastname, Institution order separated by semi-colons (e.g. Natalie Bennett, Lung Health Foundation; John Snow, University of Toronto; etc):

Question Title

* 3. What type of award are you applying for?

Question Title

* 4. Location where the research will be carried out and appointment held:

Question Title

* 5. Title of the proposed research project:

Question Title

* 6. Provide an abstract or essay describing how the funding will be used/purpose of the research (approx 500 words):

Question Title

* 7. List five key words which identify the project:

Question Title

* 8. Upload a “Letter of Nomination” (LHF BaO Young Investigators Research award ONLY)

Registration Form (Intent to Apply)
Lung Health Foundation (LHF) Breathing as One (BaO) Awards 2021-2022