ERASMUS DARWIN BARLOW EXPEDITIONS 2012
APPLICATION FORM
Please ensure that you read the guidelines before completing this form. Word
processed forms are acceptable but must follow the layout of this document
exactly.
1.
Name of project (10 words max):
2.
Name of expedition leader:
3.
Address of expedition leader:
Home address
Tel:
Mobile
Email
Institutional address:
Tel:
Mobile:
Email:
4.
Number of UK team members:
Number of host country members:
Number of members from other nations:
Total number of members:
5.
Location (Country/region):
6.
Date of expedition (to be completed by 29 February 2013):
From (dd/mm/yy):
To (dd/mm/yy):
Number of days in the field:
7.
Budget
Total
£
Total team member contributions £
8.
Summary of Expedition Objective
Describe the overall conservation aim and expected outputs (100 words
max):
9.
Details of research programme
a) Explain why and how this conservation expedition has been
developed, detailing the conservation issue/question to be addressed
(150 words max).
b) Describe the fieldwork methods to be used to achieve the expected
expedition outputs just described (400 words max).
c) How will this expedition contribute to building capacity for future
conservation work through, for example, training, provision of
technical literature etc?
10. Describe the location/region in which your conservation expedition will
be carried out including comments on access (200 words max, and A4
map of expedition area).
11. Advisors
List up to three key advisors and their expertise who have helped you
develop your research programme. Please indicate their area of
expertise.
12. Association with the host country
Give details of the form of collaboration agreed/being developed with
main government body and any other key organisations in the host
country. At what stage is the collaboration?
13. Literature Review
List up to five key publications that you have consulted to inform your
proposed research/conservation approach.
14. Permissions
Please indicate (i) the steps that have been taken to establish what
permissions are required from the host country authorities to undertake
this work and (ii) what stage you have reached in obtaining such
permissions. Please enclose copies of any permits and/or
correspondence. Tourist visas are not sufficient.
Do you intend to bring any scientific samples back to Britain? Yes/No
If ‘Yes’ please state the nature of the material you propose to export and
attach letters from the relevant authorities in your host country and UK
confirming permission to do this.
Have the following been informed of your plans?
Foreign and Commonwealth Office
(this includes your obtaining the latest relevant FCO travel
advice bulletin)
Yes/No
British High Commission/Embassy in the host country
Yes/No
Has the project been endorsed by a UK university?
Yes/No
15. Project members
List names, ages, qualifications, nationalities and languages spoken by
the leader and team members from both the UK and host country, and
give full details of a previous expedition or research experience.
University students should give the name of their institution, year of
residence and subject being studied.
16. Risk Assessment
It is assumed you have undertaken a written risk assessment of your
project. Please give details of this risk assessment and attach it to your
application form.
17. Medical skills
List the first aid training and medical qualifications of all your team
members.
18.
Health, safety and casualty evacuation
Outline the plans you have made to ensure the safety of all team members
including any plans for casualty evacuation.
19. Travel and logistics
Give an outline of your method of travel, route, accommodation and
supplies. Please indicate if an agency is helping with logistics and if so,
give details.
20. Specialist equipment
Describe any field equipment being used and previous experience in the
use of any specialised items such as GPS.
21. Budget
Please give details of your planned income and expenditure under the
following headings. If need be, please add any budget headings to the
list. 80% of the funds will be granted before the expedition and 20%
upon receipt of the reports and a final presentation.
Expenditure
Pre-fieldwork/preparation
Training
International travel (flights)
Subsistence (accommodation and food)
In-country travel
Local counterparts
Field assistants/guides
Field equipment
Insurance
£
£
£
£
£
£
£
£
£
Medical/health and safety
Film/photography
Post-fieldwork activities
Preparation of project report
Dissemination of findings
Other (please itemise)
………………………..
………………………..
Contingency (usually 10% of sub-total)
£
£
£
£
£
£
TOTAL
£
£
Income
Personal contributions
Grant giving trusts
Fundraising events and activities
Commercial sponsorship
Individuals’ donations
Other sources
£
£
£
£
£
£
TOTAL
£
22. Support to date from other organisations
State amount of any financial contribution awarded or secured from
other funding bodies. Also indicate what other funding applications are
pending or are yet to be made.
23.
Project report and other outputs
a) List the proposed outputs from the project (eg, final report, published
papers, articles, educational literature) indicating when each item will
be available. Note any planned training (eg, GIS) or other support for
local conservation professionals/students.
b) The Society requires that project teams receiving ZSL approval
submit a full report with details of the research undertaken to the
Society within six months of returning from the field. Please indicate
when the final report will be completed and to which other
organisations and authorities the report will be sent. All award
recipients will be expected to present at an expedition event to be
held during March 2013. All award recipients will be expected to
submit at least three blogs per expedition – one at the start, during
and within one month of the end of their trip.
c) List those team members producing dissertations or other degreerelated project work as a direct result of their participation in this
project. Award recipients are strongly encouraged to publish findings
and expedition experiences in as many publication types as possible
to raise awareness of the conservation themes of their expeditions.
d) Copies of all outputs should be provided to ZSL.
24. Contact address while research team is in the field
Contact details of home agent in UK and host country contact while the
research team is in the field.
Home agent:
Name:
Address:
Tel:
Mobile:
Email:
Contact in host country:
Name
Address
Tel:
Mobile:
Email:
25. Referee statements
Two referee statements are required for each application. One of these
will normally be from a university academic who can comment on the
proposed research and methodology, the other should be from an
appropriate contact in the host country, preferably from a government
representative or an academic helping with your research programme.
Your referees should not be members of the fieldwork team, nor be
directly involved in the planning of the research, and they should return
their statements directly to the Society (preferably by email or first class
post) by 31 January 2012. These are very important: your application
may be jeopardised if the referee statements do not arrive on time.
Names, and contact details of the referees:
From the UK:
Name
Address
Tel:
Email:
From your host country:
Name
Address
Tel:
Email:
26. Data Protection Act 1984
The information you have given on this form will be held on computer
and may be released to other research planners, potential sponsors
and/or the media. Please tick here if you do not wish to have this
information released.

27. Application submission – check list
I enclose:
Two copies of this application form and supporting documents,
stapled together

Two copies of A4 map of research area stapled to the back of the
form.

The latitude and longitude co-ordinates of the research area
(Question 7)

28. Declaration
The information submitted in this application is to the best of my
knowledge correct at the time this application was made. Should any
significant developments arise after this application is made, such as
change of team members or official permits being gained, I will keep the
Society informed of such developments. I have informed my two
referees that their statements should be returned directly to the Society
by 31 January 2012. Should this project be cancelled or postponed
subsequent to receiving support from the Society, I will return the grant
awarded.
Signature of Leader:
Date:
Acknowledgement of receipt will be sent by email.
Updated October 2011