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Grant Application Cover Packet Principal Investigator (Last, First, Middle): TriService Nursing Research Program (TSNRP) Grant Application Cover Packet Please type. Principal Investigator (PI) Branch of Service and Component (select all that apply) Army: Navy: Air Force: Active Duty Active Duty Active Duty Reserve Reserve Reserve Guard Guard Rank: PI Home Contact Information Address (street, city, state, zip code): Telephone: Mobile Telephone: Fax: Email: PI Military Contact Information (if applicable) Duty Title: Address: Telephone: Mobile Telephone: Fax: Email: Alternate Email: PI Civilian Work Contact Information (if applicable) Duty Title: Employer: Address: Telephone: Mobile Telephone: Fax: Email: Alternate Email: Preferred Contact Location Home Work Grant Application Cover Packet Page Retired Retired Retired Grant Application Cover Packet Principal Investigator (Last, First, Middle): Nursing Specialty (check all that apply) Community Health Critical Care Education Emergency Department Family Health Flight Nursing Health Policy Med-Surgical Nursing Administration Nursing Anesthesia Pediatrics Perioperative Nursing Population Health Management Psychological Health Women’s Health Other: Award Mechanism (check one) Research Award Mechanisms: Career Development Award Exploratory Research Award Fast Track Award Graduate Research Award Investigator-Initiated Award Military Clinician-Initiated Research Award Novice Investigator Award Evidence-Based Practice Award Mechanisms: Graduate Evidence-Based Practice Award Conceptual Guideline Development Evidence-Based Practice Award Implementation of Innovation Evidence-Based Practice Award Grant Application Cover Packet Page Research Method: (check one) Quantitative Qualitative Mixed Grant Application Cover Packet Principal Investigator (Last, First, Middle): Research Priorities Addressed by Grant Application (See Application Instructions, Section III: TSNRP Research Priorities) Primary TSNRP Research Priority (check at least one) Force Health Protection: Fit and ready force Deploy with and care for the warrior Care for all entrusted to our care Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training Leadership, Ethics, and Mentoring: Health policy Recruitment and retention Preparing tomorrow’s leaders Care of the caregiver Other: Secondary TSNRP Research Priority (optional) Force Health Protection: Fit and ready force Deploy with and care for the warrior Care for all entrusted to our care Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research into practice/evidence-based practice Clinical excellence Knowledge management Education and training Leadership, Ethics, and Mentoring: Health policy Recruitment and retention Preparing tomorrow’s leaders Care of the caregiver Other: Study Population (check all that apply) Active Duty: Reserve: Beneficiaries: Army Army Spouses Grant Application Cover Packet Navy Navy Children Air Force Air Force Retirees Page Marines Marines Grant Application Cover Packet Principal Investigator (Last, First, Middle): Is this application a revision of a previously submitted grant application? Yes No Have you submitted a grant application to TSNRP in the past? Yes No If yes, provide the year, title of the grant application, application number (e.g., N08-P04), and whether the application was funded. Begin with the most recent grant application and list chronologically. Year Title Application Number - Have you attended TSNRP’s Research Grant Camp? Yes No Have you attended TSNRP’s Evidence-Based Practice Grant Camp? Yes No Have you attended another grant writing workshop? Yes No If yes, list below. Date Sponsor Grant Application Cover Packet Method of Learning Page Funded? (Yes/No) Grant Application Cover Packet Principal Investigator (Last, First, Middle): Have you attended TSNRP’s Post-Award Grant Management Workshop? Yes No If yes, provide the date and location. Date Location How and when did you first learn about TSNRP grant awards? Grant Application Cover Packet Page Grant Application Cover Packet Principal Investigator (Last, First, Middle): Report dissemination of information related to each prior TSNRP grant award. Sort by date (most recent first). If you need additional space, write “SEE APPENDIX” in the last line of the table and include a list of your additional presentations and/or publications as an appendix to your grant application. Presentations Presenter’s Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Presentation Title Presentation Type e.g., poster, Venue conference name Date Location City, State, Country podium Publications (Provide the full citation using a consistent reference format. If applicable, indicate whether the paper is in review or in press.) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. I certify that the information above is accurate to the best of my knowledge. Signature Grant Application Cover Packet Date Page Relevance to Military Nursing Principal Investigator (Last, First, Middle): TriService Nursing Research Program (TSNRP) Relevance to Military Nursing In the space provided below, describe: 1. The relevance of the proposed research study or evidence-based practice project to military nursing clinical practice, education, management, and/or policy. 2. Either: a. How the research will produce new military-relevant scientific knowledge that will close or narrow an identified research gap, Or: b. How the project will facilitate evidence-based military nursing practice. Maximum number of characters: 2,618 Relevance to Military Nursing Page Evaluation Survey TSNRP would appreciate your answers to a few survey questions as part of TSNRP's efforts to evaluate its processes. How confusing or clear was each component of the application process listed below? Place an X in only one box per row. Very Confusing TSNRP research priorities Application instructions and guidelines Program announcement or specific information for each grant award Purpose and characteristics of each grant award Eligibility requirements Applicant organization requirements Submission process Budget requirements Timeline Scientific merit review criteria Programmatic review criteria Confusing Somewhat Confusing Somewhat Clear Clear Very Clear Evaluation Survey continued During the completion of your funding application, did you contact a member of the TSNRP staff to ask a question or seek assistance? Place one X in the row that applies. Yes No If yes, how difficult or easy was it to reach a member of the TSNRP staff who could answer your question(s) or help you? Place one X in the row that applies. Very difficult Difficult Easy Very easy During the completion of your funding application, how would you rate the ease or the difficulty of the application instructions? Place one X in the row that applies. Very difficult to understand Difficult to understand Easy to understand Very easy to understand Judging from this application experience, how likely are you to seek TSNRP funding in the future? Place one X in the row that applies. Very likely to see funding Likely to seek funding Will not seek funding Undecided