Apply for an Incyte Ingenuity Award in Vitiligo

Applications are due October 31, 2024.

You can apply for an Incyte Ingenuity Award in Vitiligo™ 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. As a next step, invited applicants will be asked to fill out a round two application form and respond to specific questions from the judging panel.

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

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

01: Eligibility Check

Please select one of the below options to confirm how you and your organization are eligible for the Incyte Ingenuity Awards 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.

Is this an ongoing/existing established program/project?

YesNo Required field

Proposed programs/projects must be separate from any existing established/ongoing activities, with the exception of considerably expanding an existing program.

Does this application feature any program/project elements that would provide financial support, gifts, or other items of monetary value to patients?

YesNo Required field

Proposed programs/projects may not provide financial support, gifts, or other items of monetary value to patients, either directly or indirectly.

Did you previously apply for the Incyte Ingenuity Awards in Vitiligo in 2023?

YesNo Required field

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

Program/Project Overview

03: Program/Project Overview

Program/Project Name Required field

Please share a short description of your program/project. (100 words maximum) Program/Project Summary Required field

Please describe the objectives of your proposed program/project and anticipated measures of success. (250 words maximum) Program/Project Objectives & Measurable Outcomes Required field

Award Selection

Please indicate which award you are applying for:

Up to $35,000 Incyte Ingenuity Award in VitiligoUp to $100,000 Incyte Ingenuity Award in Vitiligo Required field

Applicants who are submitting for less than
$35,000 apply here and note scaling below.

(Not to exceed $100,000.)

Could your proposed program/project be scaled for a lesser or larger award amount? If yes, you will be asked to provide additional details on how this amount would impact your program/project scope, intended deliverables, and other specific factors.

Yes, my award can be scaled for a lesser or larger award amount (not to exceed $100,000) and I would be willing to confirm how the different award amount will impact the proposed program/project.No, I am only interested in being considered for the award amount selected above. Required field

Acknowledgments

04: Acknowledgments

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 (e.g., through webinar, virtual advocacy day at Incyte) at milestones previously agreed upon with Incyte.
Conduct an interim and final review of the program/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 VitiligoTM

01: Eligibility Check

02: Contact & Organization Information

03: Program/Project Overview

04: Acknowledgments

Apply for an Incyte Ingenuity Award in Vitiligo^TM