This survey gathers preliminary information about research/development proposals that appear to have potential to directly prevent age-related diseases, or have some potential application to further this goal. Here, we ask for general information about your research/development proposal, including the outline of your proposal, how it applies to preventing age-related diseases, the resources you are able and willing to commit to the project if any, and estimates of funding and staff required.
* Required
Corresponding author and contact information
First Name*   Last Name*  
Title (MD, PhD, etc)  
Email*    
Phone  Ext Int'l Phone
Google ID Skype ID

Other author(s) of this submission
First Name Last Name
First Name Last Name
First Name Last Name
Confidentiality Status *
Are you OK with reviewers being allowed to consider your proposal without the burden of signing an NDA?  Note that checking "No" will severely limit the number of reviewers willing to look at your proposal, which could delay your project's progress and limit it's ability to get the attention it needs to thrive. Many reviewers are concerneed about signing NDAs because they are concerned about legal liability. Conversely, if you check "Yes" your project will more likely move into the fast lane. Don't worry, even if you check 'Yes' we will not publish information in your proposal without your permission. People will be shown your submission on a need-to-know basis only.  





 
Would you like your proposal to be published on our website? *



 
Title of research proposal *


 
Outline of research proposal and potential application to human health extension*
In 100 - 300 characters, please describe the general outline of your research proposal, and briefly comment on the relevance of this proposed research to extending healthy human life. Note: please be general and concise with this outline. We understand that scientific research proposals can be complicated, and thus will ask for greater detail and references at a later point in the proposal process.





 
Into what general area could your proposal be classified? *
Check all boxes that apply















Applications to Human Health Extension *
Check all that apply





How many FTE (full-time equivalent) personnel do you estimate this project would require to accomplish? *
If you're really not sure, please say so in order for us to avoid creating unreasonable expectations.








 
How long do you estimate the project would take, if sufficient resources are available? *
If you're really not sure about this, please say so below, so we can avoid creating unreasonable expectations.








 
Have you worked directly in the field of your proposal? If so, how long? *
No is OK






 
Scientific References or Inspiration *
Please give us at least one, but no more than three, scientific references that are fundamental to the development of, or inspiration for, your proposal. Links should be URLs pointing to the abstract/paper on Pubmed. If the reference does not exist on Pubmed, then a URL pointing directly to the abstract/paper elsewhere.
Title 1  
Link 1  
Title 2
Link 2
Title 3
Link 3



Are you actively seeking funding or other resources for this project? *

 
If funding and/or necessary resources were made available, would you work directly on the project? If so, what role do you see yourself taking? *