Apply for an Incyte Ingenuity Award in Vitiligo

Applications are due October 31, 2023.

Thank you for your interest in the Incyte Ingenuity Award in vitiligo. You can apply by filling out the below online letter of intent or by downloading this PDF letter of intent and submitting it via email to incyteingenuityawards@realchemistry.com. Based on a review of the letter of intent, applicants will be invited to submit a detailed second round application form with questions from the judging panel.

Before you begin to fill out your letter of intent, please review the following carefully:

Before submitting your letter of intent, please ensure that all information is accurate and correct, as you will not be able to edit the letter of intent after submitting it. For questions please review the FAQs or email us at incyteingenuityawards@realchemistry.com.

Letter of Intent

01: Eligibility Check

Are you eligible for an Incyte Ingenuity Award in vitiligo?

Please select one of the below options to confirm how you and your organization are eligible for an Incyte Ingenuity Award in vitiligo:

I am applying on behalf of a non-profit 501(c)(3), patient, policy, or caregiver organizationI am a healthcare provider and/or mid-level/junior faculty member of a healthcare organization and am applying on behalf of my institutionI and/or my company is partnering with either a non-profit organization or a healthcare facility (i.e., hospitals, academic research centers, etc.) to apply for this award Required field

In order to be eligible for an Incyte Ingenuity Award in vitiligo, you must fall within the above categories. If you have any questions, please email incyteingenuityawards@realchemistry.com.

Contact & Organization Information

02: Contact & Organization Information

Name of Organization Required field

Contact Name Required field

Job Title Required field

Email Address Invalid Email address

Phone Number Required field Invalid Phone Number

Address Line 1 Required field

Address Line 2 (optional)

City Required field

State Required field

ZIP Required field Invalid Zip Code

Please use this space to provide an overview of your organization and/or collaboration organization, team description, credentials/capabilities, and any anticipated outcomes. (100 words maximum) Organization Overview Required field

Please explain your organization’s involvement and relationship with the vitiligo community. (100 words maximum) Connection to the Vitiligo Community Required field

Does your proposed project involve collaboration with another organization or cross-functional team from another department?

YesNo Required field

If yes, please provide the name of the partnering organization or cross-functional team.

Project Overview

04: Acknowledgements

I have read and agree to all terms of eligibility criteria, confirm that I am applying on behalf of, or in collaboration with, a non-profit 501(c)(3), patient, policy, and/or caregiver organization or a healthcare organization/facility (i.e., hospitals, academic research centers, etc.), and have secured the necessary approvals to apply on behalf of said organization. Required field

Additionally, if you are the selected award recipient, you must:

Accept recognition by signing an agreement with Incyte
Comply with Incyte policies and any federal, state, or local requirements regarding transparency, sponsorships, and/or charitable donations
Confirm that the total amount requested in funding does not exceed 25 percent of an organization’s overall funding and does not include indirect costs
Report on the progress of the initiative to the community (eg, through webinar, virtual advocacy day at Incyte) at milestones previously agreed upon with Incyte
Conduct an interim and final review of the project with Incyte, including allocation of funding and results of the program/project
Assume sole responsibility for the payment of all federal, state, and local taxes and contributions imposed or required on income, unemployment insurance, social security, and any other law or regulation
Acknowledge that compensation and remuneration received pursuant to this program will be publicly reported by Incyte pursuant to any applicable transparency and aggregate spend laws or regulations as required
Acknowledge that if deadlines are unlikely to be met, Incyte must be informed within a predetermined timeframe, along with an explanation of the roadblock, proposed solution, and an updated execution timeline
Acknowledge that in subsequent years of the awards program, the award recipient may be asked to serve as a resource to future award recipients to share key learnings and insights

I have read and agree to all terms as outlined above. Required field

Submit Application

Apply for an Incyte Ingenuity Award in Vitiligo

Letter of Intent

01: Eligibility Check

02: Contact & Organization Information

03: Project Overview

04: Acknowledgements