Proof of Concept Fund Application Form
Project title
Applicant name
Applicant address
Applicant contact and title
(The person who will take overall
responsibility for the project)
Telephone
E-mail
Date submitted
Application reference number
(To be completed by QSTP)
Please note that the information provided in this application will be the sole document reviewed
to award Proof of Concept Fund (POCF) grants; therefore, please complete as comprehensively
as possible. A POCF Application, Eligibility and General Guide is available to support the
application process.
T +974 4454 7070 | F +974 4454 7011 | www.qstp.org.qa | Education City | PO Box 210000 | Doha, Qatar
1.
Project Details
Project Title
Provide a non-confidential, clear, and descriptive title of the proposed project.
maximum]
[15 words
Executive Summary
Provide a clear description of the following: goals, methods, technical novelty, impact,
commercial viability and expected outcomes of the project. This description should be nonconfidential. [200 words maximum]
Project Timescales
Describe the proposed timescales for the project. The project should be between 6 to 18 months.
Total Funding Required
Indicate the amount of funding required for the project.
Other Funding Granted
Indicate if other funding requests have been submitted for this project inside or outside Qatar and
whether funding has been received. List the institutions to which the requests were submitted,
the amounts received and the sources of funding, and identify at which phase/stage the funding
was obtained.
Project Location
Demonstrate how the project can be undertaken in Qatar. Is there any need to complete certain
tasks overseas? If so, why? (Limited overseas activities may be accepted if justified). Describe
any local partnerships an award would lead to. [200 words maximum]
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2.
Technology
Deliverables
Provide a detailed description of the proposed deliverables. Describe the proposed technology or
invention which to be sought under the project. Provide a brief description of what end products
or processes are expected to result from the funding or project, and their commercial impact. In
describing the proposed technology or invention, use language that a non-expert will understand.
[200 words maximum]
Significance and Impact
Describe the problem being solved or addressed, and the enhanced technical
innovation/advance sought. Explain the significance and impact of the proposed project. Assess
the potential value of the technology or invention after project completion versus the current state
of technology or invention. [100 words maximum]
Novelty
Explain how this project is innovative both commercially and technically. Use evidence to support
your belief. Evidence could include patent searches, literature surveys, competitor analyses etc.
[200 words maximum]
Technical Viability
Detail the technological development and provide evidence that the product or process will work
effectively once the project is completed. Support your justification by drawings, theoretical or
research analysis, computer simulation, etc.
Current Stage of Development
Describe the technical level of maturity reached and the percentage of work completed to date.
Identify any outstanding work that must be completed. [100 words maximum]
Regularity Requirements
Specify any international standards or regulatory requirements applicable to this project, e.g.
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privacy policies, FDA approvals, etc. List any certificates obtained or planned for submission.
[100 words maximum]
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3.
Intellectual Property Rights (IPR)
IPR
Describe and provide reference (e.g. patent numbers) to existing IP. Describe any invention and
new IP which will be developed as part of the proposed project. Indicate who owns/will own the
existing and new IP. Describe any background IP to be used for the project or IP created. [200
words maximum]
Advise any known prior art documents and patent key words used in searches.
Does the project impinge any other protected technology and, if so, how will this be overcome?
What steps can be taken to protect or establish barriers to entry?
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4.
Market
Market Assessment
Describe the target market in terms of customers and market dynamics, including the expected
customer base, market size, potential commercial returns, etc. Provide supporting data*. [200
words maximum]
Competitive Advantage
Identify any competitors working in the same technological area as that of the proposed project
or any institutes researching in this field. Describe the competing technologies of the proposed
project and what advantages your technology will have over existing competing solutions. [200
words maximum]
* Attach any independent market studies or business analysis tools used to assess the market
and business opportunity (i.e. SWOT analysis, Porter’s five forces, etc).
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5.
Commercialization
Explain how you propose to commercialize your technology (i.e. target market, sales channels,
revenue streams, monetizing strategy, partnerships, cost structure, etc.). Describe any other
commercialization objectives or potential future exploitation. Is the project likely to create a startup business, or lead to a license and royalties?
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Project Specification
6.
Key Milestones
List key project milestones and highlight expected outcomes and achievements. Specify the
amount of budget required to complete each milestone. Expand the table below if necessary.
Number
Duration
Milestone Description (30 words max each)
Budget (QAR)
1
2
3
4
5
6
7
8
9
The Team
Identify the team members to be involved in undertaking the proposed project. Attach a one
page CV of each member detailing relevant experience and skills. Expand the table below if
necessary.
Name
Role
Risk Assessment
Identify any risks that can negatively impact the project progress or outcome and how you plan to
eliminate or control them.
Risk
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Mitigation Strategy
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8 April 2015
Project Budget
Clearly specify detailed and overall costs below. Please note that only costs directly relevant to
the proposed project will be eligible. Other associated costs that are not directly relevant to the
proposed project are not allowed. At least 60% of the costs must be in Qatar.
Projected Expenditure
Budget Item
Details/Justification
Cost (QAR)
Personnel
Contractors
(maximum 20% of total funding)
Essential equipment
(maximum 15% of total funding)
Consumables
(maximum 2% of total funding)
IPR/ patent costs
(maximum 15% of total funding)
Overhead costs (maximum 20%
of direct personnel costs)
Other (e.g. travel)
(maximum 5% of total funding)
Total Cost
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7.
Applicant Profile
Applicant Name
Headquarter Location
Legal Structure
Year Established
Nature of Business Activities
Management Team
Number of Employees
0-9
10-20
21-50
51-100
Over 100
Revenue Generated (Companies only)
Specify the amount of revenue your company has generated to date in QAR. Also, indicate the
amount of revenues for the last year.
Revenues to Date:
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Revenues for the last year:
Qatar Science & Technology Park
8 April 2015
Declaration
8.

I hereby certify that the information provided in this application and all other supporting
documents is accurate.

I hereby agree that QSTP has the right to keep this application in its database.
[Applicant Name]
By: Name:
Title:
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