ESRC Impact Acceleration Account APPLICATION TO THE SLINGSHOT FUND Please refer to the Call for applications for this initiative before completing this application form. Additional information about the suitability of this initiative for your activity can be obtained from the Director of Impact Acceleration, Paul Nightingale at P.Nightingale@sussex.ac.uk. Questions about eligible costs, the application form or the selection process should be directed to Nora Davies at n.davies@sussex.ac.uk. PART 1 NAME OF PRINCIPAL APPLICANT (PA): Contact details of PA: Department Telephone Email £ Start Date End Date Title of Proposed Activity: Name, Title and Department of any CoApplicants(s) Total funding requested: PART 2 PROPOSED ACTIVITIES (maximum 1000 words) Please describe the proposed activities and how they fit with the review criteria:(i) You will need to demonstrate a need for activities from an external partner, (ii) that activities fit with a strategic engagement plan, (iii) that the fund will provide additionality, and (iv) that activities fit within ESRC remit If appropriate include a brief timetable and attached supporting documentation (including letters etc). Details should be appropriate for the amount of money requested. PART 3 ANTICIPATED OUTCOMES (maximum 500 words) Please explain the anticipated impact outcomes, and how the activities contribute towards your impact strategy. PART 4 BUDGET Provide a breakdown of the funds requested, e.g. travel and subsistence, room hire, staff costs, consumables. Description of expense Amount Time period -1- e.g. research assistant for X days @ £xxx per day e.g. Travel £ £ £ £ £ Total: STATEMENT OF SUPPORT FROM DIRECTOR OF RESEARCH & KNOWLEDGE EXCHANGE To be filled out and signed by the Director of Research & Knowledge Exchange. Please ensure: (i) The underlying research meets REF requirements (i.e. is of 2* quality or is expected to be) (ii) The level of resource requested is appropriate (iii) If the school will/could commit resources to the project, please comment below: □Yes □ No □Yes □ No Name & signature* of Director of Research and Knowledge Exchange: * An email directly from the DRKE confirming this statement can replace a signature. Please submit this form electronically to Nora Davies at n.davies@sussex.ac.uk -2-