GRAND TOTAL 4 Certification NB: all signatures must be acquired prior to the submission of this full application. Principal Investigator Certification I certify that I meet the eligibility criteria for this scheme and that all details of this application are correct (including Attachments 1-5). I agree to the guidelines set out in the Diabetes Queensland Research Fund Guidelines. I am the Principal Investigator in this project. Signature: Date: Print Name: Co-Investigator Certification I/We certify that the details in this application (including Attachments 1-5) are correct, and agree to the guidelines set out in the Diabetes Queensland Research Fund Guidelines. Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name:
GRAND TOTAL 4 Certification NB: all signatures must be acquired prior to the submission of this full application. Principal Investigator Certification I certify that I meet the eligibility criteria for this scheme and that all details of this application are correct (including Attachments 1-5). I agree to the guidelines set out in the Diabetes Queensland Research Fund Guidelines. I am the Principal Investigator in this project. Signature: Date: Print Name: Co-Investigator Certification I/We certify that the details in this application (including Attachments 1-5) are correct, and agree to the guidelines set out in the Diabetes Queensland Research Fund Guidelines. Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name:
dq_research_fund_application_form_2014_24032014.docx