KNOWLEDGE EXCHANGE AND ENTERPRISE FUNDING EPSRC IAA 2015-17 - FUNDING APPLICATION To be accompanied by pFACT Submission Report signed by Head of department and departmental administrator and Costing Tool (if applicable). Completed submissions to be emailed to: knowledge.exchange@ucl.ac.uk General Project title PI/ Academic Lead at UCL CoI (if any) UCL Department Partner Organisation (if any) Name Email Name Email Name Organisation type Number of employees Lead contact name Address Planned Activities Aims How will this contribute to creation of maximum impact from this research? How will this contribute to the embedding of a culture of enterprise and innovation within UCL? How does this plan fit in with UCL2034? Vice-Provost (Enterprise), University College London 2nd Floor, Gordon House, 29 Gordon Square, London, WC1H 0PP Tel: +44 (0)20 3108 5071 Email: VPEnterprise@ucl.ac.uk www.ucl.ac.uk/enterprise Email Activities to be undertaken (add additional pages and Gantt chart if required) Milestone definitions Description Milestone 1 Milestone 2 Milestone 3 Milestone 4 Staffing and recruitment requirements Justification of resources requested Details of Contribution from Partner Organisation (if applicable) Plan for ongoing activity and securing further funding if project is successful Commercialisation possibilities and UCLB engagement Project Track Record Summary of underpinning research (please specify link with EPSRC portfolio) Research grant details (awarding body, reference number) Measures of Success Duration Previous KE from project including details of any funding received Financial Proposed Start Proposed End (no later than 30 March 2017) Partner(s) contribution EPSRC funding requested (directly incurred costs only) Staff to be funded 1 Date Date Cash In kind Salaries with oncosts Milestone 1 Milestone 2 Milestone 3 Milestone 4 Total EPSRC funding requested Name Total Consumables and Travel Employee number UCL background Delete as appropriate Not applicable/ PDRA/technical or support staff FTE Milestone and Duration Staff to be funded 2 Name Employee number UCL background Delete as appropriate Not applicable/ PDRA/technical or support staff FTE Milestone and Duration Staff to be funded 3 Name Employee number UCL background Delete as appropriate Not applicable/ PDRA/technical or support staff FTE Milestone and Duration Expected quarterly spend profile (separate wage from other costs) pFACT costing number MyFinance Organisation Unit Departmental Administrator Name Email Total