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Application for SOHN Practice Research Grant
Society Of Otorhinolaryngology and Head-Neck Nurses
Application for Practice and Research Grant
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1.
Principal Investigator/Project Director with credentials:
(Required.)
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2.
Affiliation (Name, City and State):
(Required.)
Affiliation Name
City
State
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3.
Address, email and phone number:
(Required.)
Address
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Email Address
Phone Number
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4.
SOHN Active Member (Required):
(Required.)
Yes
No
If you are not a member of SOHN, you are not eligible to submit a grant application. Click on the following link to become a member of SOHN.
SOHN Membership Link
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5.
Co-investigators/Team members with Credentials (list all):
(Required.)
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6.
Title of Proposed Project:
(Required.)
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7.
Project Type:
(Required.)
Quality Improvement (QI)
Evidence Based Practice (EBP)
Research
Upload the following documents:
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8.
Project proposal - (typed, double spaced, references, APA format 7th ed.)
QI/EBP
- General headings should include purpose and rationale of the project, synthesis of the evidence, proposed practice change, implementation strategies, evaluation, references, and appendices.
Research
- General headings should include background/problem statement, significance to ORL or head-neck nursing, theoretical framework, research questions, aims, hypotheses, methodology, references and appendices.
(Required.)
Choose File
No file chosen
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9.
Grant Budget - Upload completed form using the SOHN Grant Budget Form below: (must login to SOHN account to download)
SOHN Grant Budget Form
(Required.)
Choose File
No file chosen
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10.
Documentation of human subjects approval (if required)
(Required.)
Choose File
No file chosen
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11.
Project timeline
(Required.)
Choose File
No file chosen
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12.
Curriculum vitae/resume of project director/principal investigator
(Required.)
Choose File
No file chosen
Thank you so much for your submission. We will review your submission and contact you once reviewed. Feel free to email info@sohnnurse.com with any questions.
