KNOWLEDGE EXCHANGE AND ENTERPRISE FUNDING KNOWLEDGE EXCHANGE SECONDMENT APPLICATION

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KNOWLEDGE EXCHANGE AND ENTERPRISE FUNDING
KNOWLEDGE EXCHANGE SECONDMENT APPLICATION
To be accompanied by: short (max 4 page) CV for the secondee (academic staff secondees
should also include a completed sabbatical leave form)
General
Call
Project title
PI/ Academic
Lead at UCL
UCL Department
Partner
Organisation
KE Secondment
Name
Name
Organisation type
Number of employees
Lead contact name
Email
Email
Address
Secondee
Name
Email
Type
Delete as appropriate
Outward (to partner) / inward (to UCL)
Project Track Record
Summary of
underpinning
research for
secondment
project
Research grant details (awarding body, reference number)
Previous KE from project including details of any funding received
Previous engagement between UCL and Partner
Vice-Provost (Enterprise), University College London
2nd Floor, Gordon House, 29 Gordon Square, London, WC1H 0PP
www.ucl.ac.uk/enterprise
Planned Activities for period on secondment
List the main objectives to be carried out
List the key stages of work to be undertaken
Describe the expected benefits to the Partner organisation resulting from the activity. Quantify the
benefits.
Describe the expected benefits to UCL resulting from the activity including the impact on UCL’s
research and teaching.
Outline the benefits to the secondee resulting from participating in this activity
Outline the future plans following successful completion
How does this plan fit in with UCL’s enterprise strategy?
Vice-Provost (Enterprise), University College London
2nd Floor, Gordon House, 29 Gordon Square, London, WC1H 0PP
Tel: +44 (0)20 3108 5071 Fax: +44 (0)20 3108 5072
Email: VPEnterprise@ucl.ac.uk
www.ucl.ac.uk/enterprise
Financial
Proposed Start
Proposed End
Directly incurred
costs requested
(£)
Staff to be funded
Date
Date
Consumables
Travel
Name
Total
Employee number
Salary spine point
UCL background Delete as appropriate
Not applicable/doctoral student/PRDA/technical or support staff/teaching staff
FTE of secondment
Date from/to
Describe overall
expected spend
profile over time
Justification of
resources
requested
Partner(s)
Contribution (£)
Direct
In kind
Total
e.g. management supervision
time, training costs, materials,
partner overheads.
*Please note these are not
fundable
Details of
Contribution from
Partner
Organisation
Cost Centre
first 2 letters of account code
Departmental
Administrator
Name
Office use only
HoD approval
Panel outcome
Funding Source
Direct Costs
Funds awarded
Estates and
Indirects Funds
awarded
Account Code
Amendments
pFACT costing
number
Salaries with oncosts
Vice-Provost (Enterprise), University College London
2nd Floor, Gordon House, 29 Gordon Square, London, WC1H 0PP
Tel: +44 (0)20 3108 5071 Fax: +44 (0)20 3108 5072
Email: VPEnterprise@ucl.ac.uk
www.ucl.ac.uk/enterprise
Email
Consumables and Travel
Total
KNOWLEDGE EXCHANGE SECONDMENT IMPACT CAPTURE
TO BE COMPLETED AT PROJECT END
General
Call
KE Secondment
Project title
PI/ Academic
Lead at UCL
UCL Department
Partner
Organisation
Name
Secondee
Name
Email
Name
Lead contact name
Address
Email
Project Track Record
Original Project Aims
Any changes made to the original aims
Detail any impact on the partner organisation’s business. as a result of the secondment i.e securing
new business, generating new profit, improving knowledge and skills of partner organisation staff
Detail any impact on UCL’s research , teaching and enterprise activity a result on the secondment
Detail any impact on the secondee as a result of the secondment
List any follow on activity being undertaken
Vice-Provost (Enterprise), University College London
2nd Floor, Gordon House, 29 Gordon Square, London, WC1H 0PP
Tel: +44 (0)20 3108 5071 Fax: +44 (0)20 3108 5072
Email: VPEnterprise@ucl.ac.uk
www.ucl.ac.uk/enterprise
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