12 november 2014
NWO
Policy Support & Devt. Dept.
(BOO)
P.O. Box 93138
2509 AC THE HAGUE
NOMINATION FOR A NWO-VON HUMBOLDT RESEARCH AWARD
UNDER THE COOPERATION AGREEMENT BETWEEN NWO AND
THE VON HUMBOLDT STIFTUNG IN GERMANY (VHS)
1 Details of the Dutch applicant
Titles
:
First name
:
Initials
:
Prefix
:
Surname
:
Male/female
:
Place and date of birth
:
Academic degrees
:
Present institute
:
Position at the institute :
Correspondence work address (street, postcode, town/city, country):
Telephone
:
E-mail
:
2 Details of the German researcher nominated for a Humboldt Research Award
Titles
:
First name
:
Initials
:
Prefix
:
Surname
:
Male/female
:
Place and date of birth
:
Academic degrees
:
Present institute
:
Position at the institute :
Correspondence work address (street, postcode, town/city, country):
1
12 november 2014
Telephone
:
E-mail
:
3 Reasons for this nomination (max. 200 words)
(nominee’s academic achievements, scientific outcome and cooperation expected to result from the award of the prize,
research interest shared by applicant and nominee)
4 Field of research
For all applications it is compulsory to fill out one or more research fields that correspond to the subject of your
research proposal. You can only refer to the descriptions and codes from the NWO research field list. Please find the
list via: http://www.nwo.nl/researchfields.
Code + main field of research:
If applicable: other fields of research, in order of relevance:
Code + other fields of research:
1.
2.
3.
Etc.
5
Host organisation and location in the Netherlands for nominee’s research visit
6 Anticipated period of collaboration with Dutch colleagues
(Please state total duration and expected starting and completion dates of the research period(s).)
……………… months, from …………………………………………… to ……………………………………………….
7 Research to be conducted during the proposed visit (max. 10 pages)
7.1
Title
7.2
Proposed research plan
7.3
Expected results
7.4
Importance of nominee’s research period in the Netherlands
8 Knowledge utilisation
(describe briefly, max. 300 words)
Potential, including:
Describe which contribution can the research make to society and/or to other areas of science? Examples are economic,
social-administrative, cultural, technological, medical or democratic areas. 'Society' is used in the sense of the entire
society and therefore both the public and private sectors.
Describe which other disciplines and which organisations can benefit from the research results? This concerns users in the
public and private sectors, including scientists in other disciplines. NB. If the research makes no societal contribution then
you need to explain this and in that case you do not need to answer the question below about the implementation.
Implementation, including:
What is the action plan to allow the outcomes of the research project (see above) to benefit potential knowledge users?
2
12 november 2014
How are the potential knowledge users involved (or how will they be involved) in the research project? Here you should
consider whether the tasks are clearly divided in advance, whether the parties concerned have been involved in
articulating the research question, how they can contribute to achieving the societal objectives and how the ongoing
involvement with users will be safeguarded. Examples are user committees, matchmaking, consortia/networks,
public-private partnerships (PPP), contract research.
If a researcher is of the opinion that the proposed research is not appropriate for knowledge utilisation then he/she
should explain why he/she thinks that knowledge utilisation is not applicable. The selection committee will assess the
arguments given for this.
9 Collaboration with Dutch colleagues during the proposed research visit
Dutch researchers (name / title / position / university & department / place) who are to work with the nominee
10 Budget requested from NWO
-
International travel expenses for nominated researcher
between ….. (place) and …… (place)
€ --------------
Subsistence costs for nominated researcher
for ...........days/weeks/months (delete as necessary)
€ ------------
Other research costs (to be specified)
€ -----------___________
Total
May any part of the costs be met by other organisations?
If so:
What organisation?
€ ------------=========
-----------------------------------------------
What amount? € -------------------11 Has any other funding application been made in relation to this proposed research visit?
What application? …………………………………………………………………………………………………….
Is a decision possible during the NWO procedure? ……………………………………………….
(If so, the NWO secretariat must be informed of the outcome.)
12 Nominee’s past research in the Netherlands
(Please state total duration and starting and completion dates)
……………… months, from …………………………………………… to ……………………………………………….
13 Past collaboration with Dutch colleagues during visits
Dutch researchers (name / title / position / university & department / place) who have worked with the nominee
14 Please enclose the following documents with the nomination form:
-
Current Curriculum Vitae of the nominee (including degrees and appointments with period, institution, city,
position; fellowships, awards and honours with dates; memberships of scientific associations with dates).
-
List of nominee’s 5 most important publications
-
Max. 2 written references from scientists attached to organisations other than those of the applicant and
nominee.
3
12 november 2014
15 Resources, equipment and required access to archives and libraries
I confirm that sufficient resources and equipment are available and that arrangements can be made to provide all access
to archives and libraries necessary to permit the nominee to conduct the research of his or her choice in the
Netherlands.
16 Signature
By submitting this document 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).
Place:
Date:
=========== =========
Signature of the Dutch applicant
====================
4