The 2016 Scholarships for New Technology Transfer Professionals from Developing Economies About the Scholarships The 2016 Scholarships for New Technology Transfer Professionals from Developing Economies1,2 (the Developing Economies Scholarship) will be awarded to up to five (5) individuals. These scholarships will: Be awarded to individuals new to the discipline who come from countries that are building technology transfer infrastructure and organizations. Provide support to attend an AUTM sponsored or co-sponsored meeting or course identified by the candidate up to a maximum level of $US 4,000, with a requirement that the applicant’s home institution fund no less than 20% of the budgeted expenses3. The scholarship must be used to attend an AUTM event in 2016. Enhance learning opportunities for members of AUTM who might not otherwise be able attend AUTM sponsored or co-sponsored meetings or professional development courses. Qualifications Candidates for the Developing Economies Scholarship must: 1. Either be members of AUTM or, if selected, join AUTM prior to receiving the award4; 2. Be employed as a technology transfer professional in an academic or not-for-profit institution in a qualifying country; 3. Have less than two years of experience as a full time technology transfer professional; 4. Have a sufficient command of the English spoken language to be able to benefit from and participate in an AUTM meeting or course. Nominations Individuals may be self-nominated, or nominated by an active AUTM member. Candidates must submit the requested information via the application form available through AUTM. There is no limitation on the number of applications from either a single institution or country, and each application will be judged on its own merit. Application Deadline Applications must be received by August 31, 2015. “Developing Economies” are those countries that are emergent in level of economic activity or impact on the world economy as defined by the World Bank – see attached list. 2 AUTM reserves the right to alter the list of Countries with Developing Economies and the list of Least Developed Economies based on classifications and definitions used by the World Bank, and based on any applicable United States export control regulations or laws. 3 All eligible budget expenses and categories are outlined in application package. The requirement for a minimum 20% co-funding from the home institution is waived for applicants from the listed Least Developed Economies. 4 Applicants need not be members at the time of application, but if not members, then an AUTM membership must be included in the budget. 1 How to Apply Complete the Developing Economies Scholarship application E-mail the application, a copy of your resume and an institutional letter of support to AUTM headquarters at slee@autm.net If e-mail is not an option, fax or express mail to: AUTM DE Scholarship 111 Deer Lake Road, Suite 100 Deerfield, IL 60015 USA Phone: +1-847-559-0846 Facsimile: +1-847-480-9282 Selection An AUTM subcommittee will make the final recommendations based upon applications received by the deadline and AUTM will announce the recipients of the 2016 Developing Economies Scholarships in early November. Selection will be based on 1. AUTM goals and guidelines for the scholarships including the awarding of at least one scholarship to a qualifying applicant from a Least Developed Economy; 2. The candidates’ applications outlining their current activities in the field, future potential contributions to the profession and their institutions, and the appropriateness of the budgets submitted; and 3. The commitment shown by their home institutions in the form of the letter of support and financial commitment. Countries with Developing Economies as Identified by The World Bank The eligible countries for the scholarship are as follows: Afghanistan Albania Algeria Angola Antigua and Barbuda Argentina Armenia Azerbaijan Bangladesh Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Central African Republic Chad Chile China Colombia Comoros Congo, Rep. Costa Rica Croatia Djibouti Dominica Dominican Republic Ecuador Egypt, Arab Rep. El Salvador Equatorial Guinea Eritrea Ethiopia Fiji Gabon Gambia, The Georgia Ghana Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras India Indonesia Jamaica Jordan Kazakhstan Kenya Kiribati Korea, Rep. Kosovo Kyrgyz Republic Lao PDR Lesotho Macedonia, FYR Madagascar Malawi Malaysia Maldives Mali Marshall Islands Mauritania Mauritius Mexico Micronesia, Fed Sts Moldova Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nepal Nicaragua Niger Nigeria Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Romania Russian Federation Rwanda Samoa São Tomé Principe Senegal Serbia Seychelles Sierra Leone Solomon Islands South Africa South Sudan Sri Lanka St. Kitts and Nevis St. Lucia St. Vincent and the Grenadines Suriname Swaziland Republic Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Uruguay Uzbekistan Vanuatu Venezuela, RB Vietnam Zambia Least Developed Economies (LDE) One scholarship will be reserved for qualifying applicants from any of the following countries: Afghanistan Bangladesh Benin Bhutan Burkina Faso Burundi Cambodia Cameroon Central African Republic Chad Comoros Congo, Rep. Djibouti Eritrea Ethiopia Gambia, The Ghana Guinea Guinea-Bissau Guyana Haiti Honduras Kenya Kiribati Kosovo Kyrgyz Republic Lao PDR Lesotho Madagascar Malawi Maldives Mali Marshall Islands Mauritania Micronesia, Fed Sts. Mozambique Myanmar Nepal Nicaragua Niger Nigeria Rwanda Samoa São Tomé and Principe Senegal Sierra Leone Solomon Islands South Sudan Tajikistan Tanzania Togo Tonga Tuvalu Uganda Vanuatu Zambia DE Scholarship Application GENERAL INSTRUCTIONS Qualifications: Applicants must: 1. Hold active membership in AUTM at the time of receiving the award. Applicants need not be members at the time of application, but if not, then a membership must be included in the proposed budget. For membership information, visit www.autm.net/join. 2. Be employed in the technology transfer profession working in an academic or not-for-profit institution in a qualifying country. (Refer to the attached list to determine which countries are qualifying countries.) Note that this scholarship is for capacity building through professional development within the profession of formal academic technology transfer. The scholarship is not intended to support educators or researchers studying technology transfer or those engaged in consulting or providing for-profit services for technology transfer or government policy advising; 3. Have less than two years of experience as a full time technology transfer professional; and 4. Have a sufficient command of the English spoken language to be able both to benefit from, and to participate at an AUTM meeting or course. The Developing Economies Scholarship application consists of the following sections: 1. Part I A and B: General Applicant Information and Curriculum Vitae 2. Part II A and B: Written Questions, Financial Information and Summary Budget 3. Part III A and B: Signatures of Applicant and duly authorized representative of Applicant’s Institution 4. Part IV Attachment: Letter of Support from the Home Institution of the Applicant SPECIFIC INSTRUCTIONS 1. FINANCIAL INFORMATION FOR SUMMARY BUDGET The summary budget in the application for the Developing Economies Scholarship includes a list of approved expense items that may be considered as components of the applicant’s proposed budget to AUTM. All applicants are required to submit a budget in the given format. A letter of support from the applicant’s institution must guarantee the co-funded component of the budget which will not be covered by the scholarship. The co-funded component of the budget is required to be no less than 20% of the total budgeted costs unless the applicant is from a LDE-listed country. The total AUTM contribution must not exceed $US 4,000. Air Travel. Defined as all air travel expenses associated with travel from home country of applicant to the closest major airport to the location of the AUTM course or meeting. All international travel must be at the lowest cost, economy round-trip airfare available from the home country of the applicant. Hotel Accommodations. Defined as all direct hotel accommodation expenses and local taxes (excluding incidental room charges such as phone calls, room service, etc.) incurred in the city where the AUTM event is occurring; hotel to be the one recommended by AUTM for the event. For travel to an AUTM event, the maximum single stay for which AUTM will provide support for any one individual is five nights. Per Diem Expenses. Defined as Meals and Incidental Expenses (M&IE) not covered by the AUTM event; the daily per diem rate allowed is $US 50.00. Ground transportation. Ground transportation is defined as all non-air travel expenses (such as local taxis, train, etc.) associated with transport to and participation in an AUTM event. AUTM Course or Meeting Registration Fee. The cost of attending an AUTM sponsored or cosponsored course or meeting. (Approximately $US 450-800) **The applicant, host institute or other local funding source, must pay these expenses. Visa Fees. ** These fees in support of applicant’s entry into the country of the AUTM sponsored or cosponsored meeting or course must be paid and budgeted by the home institution. International Health & Travel Insurance.** International health insurance is required for applicant eligibility in this AUTM grant program. This must be paid and budgeted as a local expense to be paid by the applicant/home institution or other local, non-AUTM funding source prior to leaving the home country. If exact cost is unknown, estimate $US 60 per week, and submit evidence of purchase to AUTM as a component of this application form. 2. LETTER OF SUPPORT FROM HOME INSTITUTE To be eligible for consideration, applicants must submit a Letter of Support to AUTM from their home institution signed by a duly authorized representative, in which the institution commits its support for the applicant, any dissemination plan and guarantees any funds (or those of a third party) as specified in the Summary Budget. The Letter of Support must be on the home institution letterhead, signed, and mailed or faxed directly to AUTM by the Applicant with their application. See End of Application for a Sample Letter DE Scholarship Application Complete the following form and submit to AUTM for review. Incomplete applications and applicants who do not meet qualifications will not be considered. Note that AUTM may request additional information for consideration. Failure to comply with requests for supporting information could be grounds for disqualification. Remember the Application Deadline is August 31, 2015 PART I A – GENERAL APPLICANT INFORMATION Given/First Name Surname/Family Name/Last Name Title University or Institution Name Address City State/Province Country Postal Code Phone (Indicate: work, home or mobile) Alternative Phone (Indicate: work, home or mobile) Email Fax PART I B – APPLICANT CURRICULUM VITAE ATTACH A COPY OF YOUR CURRICULUM VITAE (RESUME) PART II A – APPLICANT QUESTIONS AND BUDGET: QUESTIONS: Answer all questions completely but in brief, i.e. in fewer than 200 words. a. Provide a short description of your institution, focusing on: (i) Major research activities (ii) Technology transfer infrastructure and activities (mention the age and size of your office) (iii) Governmental policies and technology transfer support programs b. Describe your role in your institution and your role in implementing your institution’s technology transfer policy and activities. Include a summary of your experience so far in technology transfer and any AUTM events you have attended so far. c. What are your personal career goals in technology transfer and what areas of technology transfer interest you most? d. Which AUTM event do you wish to attend and why? AUTM hosts many meetings and training courses (national, regional and international) throughout the year – a list of upcoming events can be viewed on the AUTM website, www.autm.net/events. A winning candidate may attend any AUTM meeting or course of his/her choosing but must specify it at this time. You should also indicate how this scholarship and attendance at this AUTM event will help you achieve your goals as a technology transfer professional. e. A strength of AUTM as represented by the professionals comprising it, is the willingness of its membership to share expertise. Describe your plan to share what you have learned at AUTM with other people at your home institution and/or in your region on your return? Note: AUTM will request information on the success of this plan six months after event attendance. PART II B - SUMMARY BUDGET Unless you are applying from a country on the attached Least Developed Economies listing, the Home Institution must contribute at least 20% of the total budget as set out below. I am applying from a LDE listed country: __yes ___no Category Amount Requested From AUTM (in U.S. Dollars) Amount To Be Provided By Institution or Other Non-AUTM Source (in U.S. Dollars) Notes Air Travel From Home to Nearest Airport to Event Ground Travel Expenses Taxi, Bus or Train etc. Hotel Accommodations AUTM recommended accommodation for venue AUTM Registration Fee AUTM Meeting or Course AUTM Membership Fee If Not A Member Per Diem Expenses (daily meals, etc. ) Meals, etc., other than those covered by meeting Health Insurance** Must be covered by Home Institution Visa Fees** Must be covered by Home Institution AUTM Contribution $ Requested (Not To Exceed $US4,000) Home Institution Contribution $ Must be not less than 20% of Total Budget, unless from LDE listed country Total Budget $ **If you are not applying from LDE listed country, health insurance and visa fees must be paid by the host institution or other non-AUTM funding source. PART III A – APPLICANT SUBMISSION AND SIGNATURE Application Deadline: The application deadline is August 31, 2015. Send your completed application to AUTM: By email to: slee@autm.net Or by fax to: +1-847-480-9282 Or by express mail to: Subject line: AUTM DE Scholarship Submittal AUTM Attention: DE Scholarship 111 Deer Lake Road, Suite 100 Deerfield, IL 60015 Telephone: +1-847-559-0846 NOTE: Applications should only be submitted once either by fax, email or mail. If you are unsure whether your application has reached us, contact Sheila Lee at slee@autm.net to ensure it has been received. I wish to be considered for support under the AUTM Scholarship Program to Attend: _______________________________________________ AUTM Sponsored or Co-sponsored Event Applicant Signature Print Full Name Date PART III B – HOME INSTITUTION ATTESTATION OF SUPPORT Applicant: Ensure that you attach a letter of recommendation in support of your application from your Institution (employer) as well as having an authorized institutional representative sign below. A sample letter is provided in these instructions. The contents of the letter should cover all of the information outlined in the instructions. Note: Given the complexities of international travel today, AUTM requires clear acknowledgement of the responsibility of your institution to: 1. Meet the costs and relevant administrative requirements of your visa application to attend either an AUTM meeting or course; and 2. Ensure Health and Travel Insurance cover for the applicant for any illness or accident that might occur during the period of traveling to, from and while attending the AUTM event. By signature below the Home Institution indicates its support for this applicant’s application and travel to the AUTM event should the scholarship be awarded: Institution Authorized Signature Print Full Name Date PART IV– HOME INSTITUTION LETTER OF SUPPORT Home Institution Sample Letter– Fill Out and Copy on to Letterhead [DATE] Reference for: [Applicant Name] AUTM 111 Deer Lake Road, Suite 100 Deerfield, IL 60015 USA Dear AUTM, This letter is a commitment by this institution to support the professional development of [Applicant name] by allowing them to attend the AUTM meeting or course indicated in the enclosed application and to provide [Fill in US $X] as a cash contribution in support of [Applicant name] for the enclosed application submitted to AUTM. This letter hereby confirms that [Applicant name] is new to the profession and has been active in technology transfer at our institution for a period of no more than two years. On behalf of this institution, I guarantee [Fill in US $X] the following direct contributions (or guarantee of other third party support) to this Scholarship and as part of this will be fully responsible in ensuring all of the appropriate fees, applications, and insurance are covered as per travel Visa and full Health / Travel Insurance coverage: Cost (U.S. Dollars) BUDGET CATEGORY 1. Applicant cost of Visa Fees [Fill in US $A] 2. Applicant cost of purchasing International Health and travel Insurance fees [Fill in US $B] 3. Additional Contribution to be provided For _______________________________ [Fill in US $C] Home Institution Total Commitment $ [Fill in US $X=A+B+C] It is understood that proof of Health and Travel Insurance coverage may be requested by AUTM. The terms of this commitment letter will expire one (1) year from the execution date unless the scholarship is approved by AUTM and accepted by the recipient, whereupon it will expire when the commitment is fulfilled or the recipient does not accept the scholarship. Sincerely, ____________________________________________ Signature Home Institution Authorized Representative ____________________________________________ Printed Name ____________________________________________ Title __________________ Execution Date