University of Warwick
Warwick Impact Fund 2011-2015
Application for Proof of Concept Awards
Applicant Details
PI Name
PI Status: Please confirm that you have
12 months to run on your contract (if
applicable) from the start date of this
activity.
Department
Email
Phone
Mobile
Co-Investigators and Departments
External Collaborators and Affiliation
(if applicable)
Date of Application
Project
Project Title
Start Date
End Date
Warwick Ventures COAP No.(if any)
COAP Score
Total Estimated Project Cost
Grant Requested
Source and amount of any additional
funding
Project Summary (max 200 words)
Pre-PoC Research Funding Bodies
Please list external funding bodies who have contributed to the pre-PoC research
(e.g. EPSRC, Wellcome Trust etc.)
Case for Support (max 4 sides of A4 )
Brief Background and Current State of Market
Commercial and/or Exploitation Potential
Current IP Position (eg expectations of current/previous collaborators)
Project Activity
Brief Timetable (of milestones and/or deliverables)
Has an earlier or different version of this
project been submitted to any external
bodies previously? Please provide details.
Are you aware of any similar activity that
has taken place at other organisations?
Please provide details.
Financial: Please break down all financial elements by Financial Year.
Note: Proof of Concept projects are normally of <6 months duration and in any case may not extend
past 12 months.
2011/12
2012/13
2013/14
2014/15
Total Cost of Project
Amount of Funding
Requested from
Impact Fund
Funding from
grants
Funding from other
sources
Expenditure
Staffing
Travel and
Subsistence
Equipment
Consumables
Facility Charges (if
applicable)
Other (please
specify)
Total expenditure
Head of Department: Statement of Support
Warwick Ventures Ltd: Statement of Support
Total