TA CatC1Chem Grant Grant application form TA Catalytic C1 Chemistry 2015 Please refer to the ‘Guidelines for Application TA CatC1Chem’ when completing this form Please write your application in English and make sure that your application is easily readable. We advise a minimum font size of Verdana 8.5 pts. Your application should be comprehensive as a separate entity. Project details 1. Basic details of the project 1a. Title of the proposal (As short as possible, yet specific. Equal to the title entered on the project information screen during submission.) 1b. Project acronym 1c. Project duration: … months 2. Details of the applicant(s) 2a. Contact details of all applicants Main Applicant / Principal Investigator (PI) Name, first name, title(s) male / female Date of birth Position Date of PhD professor / associate professor (UHD) / assistant professor (UD) / other: End contract University Department Section Postal Address Zip/city Telephone E-mail Co-applicant (copy/paste as many times as needed) Name, first name, title(s) Date of birth Position male / female Date of PhD professor / associate professor (UHD) / assistant professor (UD) / other: End contract University Department Section Postal Address Zip/city Telephone E-mail 2b. Past performance of the applicant(s) (max. ½ page per applicant and a maximum of five relevant publications per applicant) Items can be: (scientific) publications, patents, inventions, products successfully introduced to the market, etc. 3. Summaries of the research proposal 3a. Scientific summary (max. ½ page) 3b. Formulation of the main goal(s) of the project (max. 3 lines) 3c. Public summary (Please provide in Dutch and English: ─ A popular/catchy title of the project ─ A text summarizing the essence of the project in easily accessible language (about 50 words). These summaries will be published on the NWO website in case the project is granted.) TA CatC1Chem Grant Grant application form TA Catalytic C1 Chemistry 2015 Please refer to the ‘Guidelines for Application TA CatC1Chem’ when completing this form 4. Classification of the proposal 4a. Field(s) of research (For all applications it is compulsory to fill out the main research field that corresponds to the subject of your research proposal. If applicable you can also select other relevant fields of research. The research fields have no relation to the NWO science divisions. You can only refer to the descriptions and codes from the NWO research field list. Please find the list via: www.nwo.nl/researchfields ) Field(s) of research in order of relevance 1. 2. 3. give code + field of research (compulsory) give code + field of research (if applicable) give code + field of research (if applicable) 4b. Keywords (max. 6 keywords; keywords will be used to find appropriate referees) 5. Other grant applications (Has/Have any additional grant(s) for this project or a similar research topic been requested either from NWO or from any other institution/funding agency? If so, please describe below; copy and paste table as often as needed.) title proposal: applicant(s): funding agency, budget applied for: date of submission, date of decision: Research proposal (max. 6 pages in total for section 6) 6. Full description of the proposed research (Maximum 6 pages, literature references in section 7. See also the evaluation criteria in section 4.2 of the ‘Call for Proposals TA Catalytic C1 Chemistry’. The description should illustrate the scientific quality, the innovation and valorisation potential of the research proposal and its fit to the scope of the programme.) a. Aim/objectives (incl. the state of the art) b. Scientific and technological approach (incl. pitfalls & solutions and impact)/time scheme c. Scientific novelty d. Innovation and valorisation potential (Describe in what manner the output of the proposed research will initiate or improve innovation and valorisation. Describe the possible involvement of end users and valorisation partners.) e. Transfer of knowledge (briefly describe how the project results are disseminated) f. Project milestones and deliverables (specify the milestones and deliverables – description, due date – throughout the duration of the project) Project Objectives Number Description Project Milestones Milestone# Description Relates to objective # Number format = objective number.milestone number * Counted from the actual start date of the project 2 Due month * Responsible partner TA CatC1Chem Grant Grant application form TA Catalytic C1 Chemistry 2015 Please refer to the ‘Guidelines for Application TA CatC1Chem’ when completing this form Project Deliverables Deliverable# Description Relates to objective Due month * Responsible partner # Number format = objective number.deliverable number * Counted from the actual start date of the project g. (Scientific) Embedding of the proposed research: background, (inter)national position, collaborations, co-operation along the chain of knowledge with academia and/or industry relevant for the execution of the project. (In kind contributions) 7. Literature references (Please refer to ‘open’ literature only.) Budget 8a. Summary of requested funding within the total budget Please give the budget for the project in k€. The maximum duration of the project is five years. Summary of the budget Personnel Consumables Equipment Total k€ … total k€ … total k€ … total k€ 289.452 maximum inc. TKI allowance) Specification … … … … x x x x PhD (k€ 209*) pd-1yr (k€ 69*) pd-2yr (k€ 139*) pd-3yr (k€ 207*) *Estimation of the maximum amount including a fixed bench fee (VSNU tariffs) 8b. Project part spent with TKI allowance Amount of TKI allowance to be applied for (1/13 part of total, based on 25% allowance on the private contribution (which is 50% of the NWO contribution)): € … Specification: Please also indicate in the table in 8a. 8c. Justification of requested financial support (Please justify the requested budget.) Statement 9. Statement by the PI By submitting this form through Iris, I declare that I have completed this form truthfully and I declare that I have informed the correct official(s) of my employing institute of this submission (e.g. the scientific director or dean). By submitting this form I declare that I satisfy the nationally and internationally accepted standards for scientific conduct as stated in the Netherlands Code of Conduct for Scientific Practice 2012 (Association of Universities in the Netherlands). Name: Place: Date: 3 TA CatC1Chem Grant Grant application form TA Catalytic C1 Chemistry 2015 Please refer to the ‘Guidelines for Application TA CatC1Chem’ when completing this form Please submit the application form (pdf format is required!) accompanied by the separate PDF file listing the suggested referees to NWO in electronic form using the Iris system, which can be accessed via the NWO website (www.iris.nwo.nl). The application must be submitted from the account of the main applicant. The Excel file containing the referee list can be downloaded via the call website. For any technical questions regarding submission, please contact the IRIS helpdesk (iris@nwo.nl). 4