For internal use
Canada/Germany 2015 Joint Program
Full Application
File # :
DEADLINE: 15th January, 2016
This form must be filled in with “Arial 11” font, typed at 1.15 line spacing
TITLE OF THE PROJECT (In English)
TITLE OF THE PROJECT (In French)
DELIVERABLES
IDENTIFICATION OF THE PRINCIPAL INVESTIGATOR (PI) (Canada)
Last Name:
First name:
Organization/University:
Department/Faculty:
Address:
City:
Country:
Province:
Postal Code:
Phone #:
Ext:
Email:
IDENTIFICATION OF THE PRINCIPAL INVESTIGATOR (PI) (Germany)
Last Name:
First name:
Organization/University:
Department/Faculty:
Address:
City:
Country:
Email:
Full Project Application
Province:
Phone #:
Postal Code:
Ext:
CONFIDENTIAL
SECTION 1. IDENTIFICATION OF THE RESEARCH GROUP (PIs and CO-INVESTIGATORS). Add lines if necessary
Numeration
(to be used
in sections 6
and 12)
Name
Affiliation
(Organization, Country)
Email
% of the
Contribution Academia
budget
to the
or private
allocated to
project
sector
this group
Discipline
1
2
3
4
5
6
7
8
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SECTION 2. PROJECT SUMMARY (maximum 1 page)
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SECTION 3. SUMMARY FOR LAY AUDIENCE AND PRESS RELEASE (in both English and French, maximum ¼ page each)
(In English)
(In French)
SECTION 4. KEY WORDS (up to 5 words that describe the project, in both English and French)
English
French
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CONFIDENTIAL
SECTION 5. DESCRIPTION OF THE PROJECT (maximum 10 pages)
Describe the project by outlining the following aspects of your research:
 Rationale
 Background and preliminary results
 Objectives
 Research Plan
o Methodological approach (Include appropriate power analysis for animal and human studies. For
human studies, define the recruitment process and elaborate on your ability to recruit the necessary
number of patients.)
o Principal steps
o Expected results
o Milestones and go/no go decision points: Milestones are major events or significant steps in a
project. Make sure to define your project with a milestone at every 6 months. Each milestone should
be accompanied with a specific set of metrics that allows a third party to assess progress. If the
project is completely dependent on a specific milestone, address it as a go/no go decision point.
o For this particular initiative with AIF, the German partners will have a go-no go decision at yr. 1 in
order to proceed with the second phase of the project (see details in the call for projects)
o Deliverables: The deliverables are the concrete, tangible work products. Define clearly the tangible
assets that will result from your work and its intended use in the drug R&D process. Additionally,
explain how the deliverables may be transferable to and used by the industry in biopharmaceutical
research.
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SECTION 6. TIMELINES OF THE RESEARCH PROJECT (maximum 1 page)
1. Insert the principal steps of the project as well as milestones, deliverables and go/no go decision points (as
described under section 5) in a Gantt chart.
2. Identify in the Gantt chart the specific contribution of each PI and co-investigator (by referring to the
numbers associated with the investigator as listed in Section 1) at the different steps of the project and
specify the cost of each step.
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SECTION 7. INNOVATIVE CHARACTER OF THE TECHNOLOGY, POSITIONING AND INTERNATIONAL COMPETITIVENESS OF THE
PROJECT (maximum 1.5 pages)
1. Describe the originality and the innovative character of the proposed research (technology, computational
tool or device).
2. Describe the market targeted by the technology, computational tool or device derived from the research
proposal (if applicable).
3. Identify the most important international competing technologies, computational tools or devices (existing or
in development; direct or indirect) that aim to achieve the same goal as your proposed project, by a similar
or different technology. Clearly state the names of competing teams in academia and in private
organisations.
4. Position and compare your proposed technology, computational tool or device with respect to the identified
competition (at the local and international levels) focusing specifically on the scientific and usability aspects
of the technology, computational tool or device and not on the excellence of the team and/or facilities.
5. Describe the added value of the technology with regard to future potential applications and the international
competing technologies used to achieve similar readout or goals.
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SECTION 8. IMPACT OF THE PROPOSED RESEARCH (maximum 1.5 page)
1. Impact on the drug discovery and/or development process:

Explain how the generated results/deliverables are expected to impact the drug discovery and/or
development process in the near-term following completion of the project;

Identify the most important challenges currently faced by the pharmaceutical industry in relation to
personalized medicine and describe how your proposed project will address them;
 Describe how the proposed research will address important challenges in biopharmaceutical research.
2. Select which main step(s) of the drug discovery and/or development process your project is most likely to
impact:
Target identification
Discovery / screening
Lead optimization
Preclinical studies
Clinical development
3. Socio-economic impact of the project (for Canada, Germany).
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CONFIDENTIAL
SECTION 9. DESCRIPTION OF THE RESEARCH TEAM (maximum 2 pages)
1.
2.
3.
4.
Discuss the role of the PIs and co-investigators in the achievement of the research.
Describe their experience and expertise relevant to the proposed research.
Discuss the synergies and complementarities of the team.
If the researchers are affiliated to a private organization:

Provide some corporate information;

Describe how the organization is qualified in relation to the achievement of the research;

Discuss how the proposed research is integrated into the overall corporate objectives of the company.
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SECTION 10. LONG TERM DEVELOPMENT PLAN & COMMERCIAL OPPOTUNITIES
The focus of this competition is on innovative technologies or products that can be implemented in pharma or
brought to market within the very near term on completion of the 3-year funding period. Please outline how you
envision this to occur by detailing the overall anticipated plan, identifying who would perform this, and additionally
the time required to implement the plan, as well as its associated costs.
Describe the commercial opportunities that the newly developed technology will open:
 Outline the commercial opportunities your technology will yield in the biopharma R&D sector.
 Describe the technical development plan that would be required to commercialise the technology
(manufacturing, scale-up, regulation, foreground and background IP, etc.), including a brief tentative
timeline.
 If applicable, briefly discuss how will funding of this project will create synergistic value for your organization
and how is the project aligned with corporate goals.
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SECTION 11. RISK MANAGEMENT (maximum 1 page)
Describe the potential risks associated with the project as well as their levels of significance. Explain how you intend
to manage these risks. The risks may include technical and scientific challenges or may be related to human
resources, access to specific material, infrastructure support, IP or other issues.
Please use the following table (add lines if necessary)
Risks
Impact on the project
Probability of
occurrence
Risk mitigation
Technological
Human resources
Access to specific
material
Infrastructure
Financial
IP
Others
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SECTION 12. INTELLECTUAL PROPERTY
12.1 IS THERE ANY PRE-EXISTING INTELLECTUAL PROPERTY (IP) LINKED TO YOUR PROJECT?
Yes
No
If yes, please answer the following questions (maximum 1 page):
1. Who are the IP owners?
2. What is the invention?
3. Who holds the rights to the IP?
4. Do the principal investigator and the co-investigators of this project have the legal authorization to use the
pre-existing IP?
5. Are there any commercial relationships or agreements (e.g. licensing agreements) with regards to the preexisting IP? If so, please describe.
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12.2 WILL YOUR PROJECT GENERATE NEW INTELLECTUAL PROPERTY (IP)?
Yes
No
If yes, please describe (maximum 1 page):
1. The technology that will result in the creation of the new IP.
2. Who will be the inventor(s)?
3. Who will hold the IP rights? Is that person/organization aware of the CQDM licensing policy (described
under Section 6 of the guidelines)?
4. Describe the overall strategy regarding data and IP sharing.
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SECTION 13. FINANCIAL ASPECT OF THE PROJECT
Please, report here the first page from the financial table.
13.1 TOTAL FUNDING
Year 1
Year 2
Year 3
Total
Amount requested from CQDM ( in Dollars $)
Amount requested from Germany ( in Euros €)
TOTAL PROJECT (in Dollars $ and in Euros €)
13.2 BUDGET
Year 1
Year 2
Year 3
Total
Canada
$
Germany
€
Canada
$
Germany
€
Canada
$
Germany
€
Canada
$
Germany
€
0
0
0
0
0
0
0
0
Materials and supplies2
Travel expenses (conferences,
seminars, symposia, fieldwork,
collaborations)
Publication and dissemination
costs
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Services3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
ESTIMATED COSTS OF THE
PROJECT
Salaries and benefits (research
staff, payment to students) (see
next section for more detailed
salary budgeting)1
specify)4
Other (please
Overheads (maximum 15%)
GRAND TOTAL OF
ESTIMATED COSTS
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SECTION 14. SIGNATURE OF PIs AND ALL CO-INVESTIGATORS (add pages, if necessary)
Please note that the full proposal must be signed by the PIs and all the co-investigators
1. I authorize CQDM, Germany to exchange all information relating to this application for analysis or
evaluation purposes, provided that all persons granted access to this information treat it in the strictest
confidence.
2. I understand that the intellectual property resulting from this project will belong to the inventor(s) and
their institutions and that a non-exclusive end-user license option will be granted to the CQDM
industrial sponsors. The terms of said license option will be negotiated before the beginning of the
project no later than 3 months following the confirmation of the funding.
3. I agree that, if this project is retained for funding, I will facilitate the signing of an agreement with
respect to the option on the IP generated by this project.
4. I certify that all information provided in this application is complete and accurate to the best of my
knowledge.
Signature of the PI (Canada):
Name:
Date:
Signature of the PI (Germany ):
Name:
Date:
Signature of the co-investigator:
Name:
Date:
Signature of the co-investigator:
Name:
Date:
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CONFIDENTIAL
RESEARCH ENTITIES SIGNATURE (add pages, if necessary)
1. I certify that I am a signing officer of the research entity representing investigator(s)* _______________________
________________________________________ and that I have the authority to commit the research entity with my sole
signature.
2. I read the content of this application and I certify that the information provided in this form is complete and accurate to the
best of my knowledge.
3. The research entity supports this application and agrees to provide the functional laboratories or research facilities and the
equipment necessary for conducting this research project.
Signature :
Name:
(Print)
Title:
Organization :
Date:
*List the name(s) of the investigator(s) submitting this application who are affiliated to your research entity.
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