Nonclinical form

Nonclinical concept submission has a prerequisite of preliminary discussion having occurred with a representative of the Amgen Global Medical Organization.

To avoid loss of data, please plan to submit your application form in its entirety within one login session. It is recommended that you review the form prior to actual submission to determine information being requested (submitted or cancelled forms cannot be retrieved).

Once you have gathered all the required information, please allow at least 30 minutes to complete the form (the session will timeout within one hour from login).

In-scope:

  • Funding application for a Nonclinical concept related to an Amgen asset, that has been discussed with a representative of Amgen Global Medical Organization.

Out-of-scope:

Principal Investigator (PI)

Submission Date:

February 14 2022 04:22:02

    Representative of Amgen Global Medical Organization with whom this proposal was discussed prior to submission

    Study Proposal

    "Amgen Product" identifies Amgen product most likely related to study (including where drug support is not being requested, i.e., Observational studies).

      20,000 characters max. Consider including preliminary data supporting your hypotheses; starting hypotheses, objectives, originality, and the feasibility of the project.

        1 page max. Must include description of animal procedures (if applicable) and humane end points, i.e. management of pain and distress

          20,000 characters max. Consider including a discussion on limitations and alternatives.

          Support Requested

          All costs provide in USD and exclusive of any taxes. Not all sections should be completed. Complete fields applicable to your proposal. If the proposal is approved for funding, be prepared to provide additional supporting information (e.g. for labor: hourly rates, % time dedicated to the project, …).

          Category

          Labor

          (USD)

          Consumables

          (USD)

          Equipments

          (USD)

          Subtotal

          (USD)

          Overhead (indirect) cost rate

          (%)

          Overhead (indirect) cost

          (USD)

          Total cost

          (USD)

          Total amount requested for the full proposal

          (USD)

          Category
           Year1 From* To*

          Labor *

          Consumables (USD)*

          Equipments *

          Subtotal (USD)

          Overhead (indirect) cost rate (%)*

          Overhead (indirect) cost (USD)

          Total cost (USD)

          Total amount requested for the full proposal (USD)

          Category
           Year2 From To

          Labor

          Consumables (USD)

          Equipments

          Subtotal (USD)

          Overhead (indirect) cost rate (%)*

          Overhead (indirect) cost (USD)

          Total cost (USD)

          Total amount requested for the full proposal (USD)

          Category
           Year3 From To

          Labor

          Consumables (USD)

          Equipments*

          Subtotal (USD)

          Overhead (indirect) cost rate (%)*

          Overhead (indirect) cost (USD)

          Total cost (USD)

          Total amount requested for the full proposal (USD)



          List out all materials, including controls and any back-up molecules, which Amgen will be providing in support of the request

          Describe your publication goals

          References cited in the research proposal

            Submission

            If this request includes experiments in animal models and support is granted by Amgen (e.g. funds, compounds, research reagents, …), by submitting this form you are attesting that you will have obtained the authorization from your local ethical committee (e.g. IACUC) prior to starting these experiments.

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