Science Week Festivals Call 2016
Application Form
-----------------------------------------------------------------------------------------------------------Deadline for Submission
Completed documents must be received by 17.00 hours (Irish Time) on Tuesday, 5 April 2016
Applications must be submitted in PDF format by email to discover.programme@sfi.ie
-----------------------------------------------------------------------------------------------------------Section A:
To be completed by all applicants
Section B:
To be completed by Non-Eligible Research Bodies
Section C:
To be completed by Eligible Research Bodies
Appendices:
To be completed by all applicants
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Application Form – Section A
to be completed by all applicants
1.
Organising Committee
Outline the structure of the organising committee for your Science Week Regional Festival. Indicate which roles
will be undertaken by each individual. Refer to the required skills outlined in the Guidance Document. A one page
CV written with relevance to this application to outline the relevant skills and experience being provided by that
individual should be included in Appendix A. Letters of Support from relevant organisations outside of the Project
Lead’s should also be included in Appendix A.
Project Lead
Person responsible for delivery of outputs and impact of the project and central contact point for the project.
Full Name:
Title:
Job Title:
Organisation:
Address:
Contact Telephone Number:
Email Address:
Role in Project:
Project Team
Individuals responsible for a variety of roles required in the project – both internal and external to the Project
Lead’s organisation. Roles should be clearly defined.
Full Name:
Title:
Job Title:
Organisation:
Address:
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Contact Telephone Number:
Email Address:
Role in Project:
Full Name:
Title:
Job Title:
Organisation:
Address:
Contact Telephone Number:
Email Address:
Role in Project:
Full Name:
Title:
Job Title:
Organisation:
Address:
Contact Telephone Number:
Email Address:
Role in Project:
(the above table may be duplicated as required).
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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2.
What is the geographical reach of your festival? (List counties you intend to promote to)
3.
When will your festival take place?
Start Date:
4.
dd/mm/yy
Finish Date:
dd/mm/yy
What will your festival comprise of?
Provide examples of the various types of content proposed and where and when they are likely to take place.
Event Type
Event Title
Location (e.g. library, academic
institution, community centre)
Target
Audience
Reach
Open Day
Events for
Families
Evening Events
aimed at an Adult
Audience
Other, please
define
5.
Audience
Which of the target audiences identified in the guidance document will your festival address?
(You must choose two or more of the following)




C2DE Socioeconomic groups
Adults (attending without children), in particular ages 35 - 55
Teenagers (13 – 16 age cohort)
Low intervention counties, please specify :
Carlow

Cavan

Kerry

Leitrim

Monaghan

Roscommon

Clare
Louth


SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Please detail how your festival will address the specific audiences identified above:
Who else is your festival aimed at, if applicable?
 as appropriate
Young People 12 years age and under
Young People between 12 -16 years age
Young People between 16 -18 years age
Young adults between 18-25 years age
Adults aged 25+
Parents
Teachers - Primary
Teachers – Second Level
Career Guidance Counsellors
General Public
Schools – Primary
Schools – Second Level - Junior Cycle
Schools – Second Level – Senior Cycle
Other (please specify below)
6.
Outline your marketing plans to reach your target regional audience? (500 words)
7.
Outline the content for each element of your proposed Science Week Regional Festival
Provide examples of the various types of content proposed.
Event Type
Open Day
Schools Events
Proposed Content
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Events for
Families
Evening Events
aimed at an Adult
Audience
Other, please
define
8.
Indicate how your festival will address areas of festival content identified in Section 2.3 of the
guidance document (max 500 words)
9.
Finance
How much will your Science Week Regional Festival cost?
There are no fixed limits on the amount that can be requested up to a maximum of €35,000 but all costs
need to be reasonable and justified and will undergo cost challenge. A budget in excess of this
threshold for will be considered for the Dublin Science Week Festival.
2016
€
Project management
Content development costs
Direct activity and production costs (include venue, AV, catering etc)
Marketing and promotion (include website)
Consumables
Training (including front of house volunteer training)
Evaluation
Expenses (e.g. travel)
Other – details must be provided
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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How do you propose to fund this project?
We would like to understand how you propose to fund this project. Applicants should demonstrate
how funding/in-kind contributions are being sourced from other partners to deliver this project.
How much funding are you requesting from Science Foundation Ireland
under this Call?
List project partners and their contribution to the project including funding/in-kind contribution as
applicable. Any income derived from the project should also be included here.
Partner Organisation
Contribution to Project
Cash
€
In Kind
€
Budget Justification / Clarification
If you would like to clarify or provide justification for the project costs, please do so below. (500 words max)
10. How will you measure success?
Outline project outputs and outcomes and outline how you will evaluate whether they have been
achieved. (500 words max). Refer to the SFI Discover Programme Evaluation Toolkit here.
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Application Form – Section B
to be completed by Non-Eligible Research Bodies in relation to the Project Lead’s Organisation
Please ensure that you complete all parts of Section B
1.
Organisation Details
Organisation Name:
Address:
Telephone Contact Number:
Email Address:
Legal Status: e.g. company limited by
guarantee, limited company etc.
Registration Number (including Charitable
Registration Number)
Auditors:
Name:
Address:
Telephone:
Email:
Partner with
responsibility for Audit:
Solicitors
Name:
Address:
Telephone:
Email:
Bank:
Name:
Address:
Telephone:
Account Officer:
2.
3.
Organisational Structure & Management
Please provide details of your organisation structure in chart form, detailing positions and names of post
holders.
Documentation to be provided with the application
Please supply ALL of the following information:
1.
2.
3.
A copy of the most recent Annual Report
A signed copy of the most recent Audited Financial Statements (if applicable)
A copy of the organisation’s current valid Tax Clearance Certificate
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Application Form – Section C
To be completed by Eligible Research Bodies
Eligible Research Body – Cover Sheet for Proposal
Programme Name:
Science Week Festivals Call 2016
Closing Date:
17.00hours (Irish Time) on Tuesday, 5 April 2016
Title of Proposal (10 words maximum):
Name of Host Institution:
Project Lead’s Name:
Total Project Budget:
Total Funding Requested:
Project Start Date:
Project End Date:
Project Duration:
Signatures below confirm acceptance of and agreement with the Grant Terms and Conditions of the SFI
Discover Programme Call (as outlined in the Science Week Regional Festivals Call 2016), that the applicant
meets eligibility requirements and all details provided are correct.
Institutional Signatory Authority
Name:
Position:
Contact Telephone Number:
Email:
Correspondence Address:
Signed:
Date:
Project Lead
Name:
Signed:
Date:
This cover sheet must be stamped with the official stamp of the relevant institution.
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Appendices
To be completed by All Applicants
Appendix A: Project Team CVs
One page (max) CVs for project team members written with relevance to this
project to demonstrate the skills and experience necessary to deliver the
responsibilities to the project.
Letters of Support from all relevant organisations outside of the Project Lead’s
organisation.
Appendix B:
Track record in STEM Education and Public Engagement (max 4
pages)
Please provide details of track record in Education and Public Engagement which
should include any relevant current projects – audiences reached, evaluation
reports, project partners etc.
Appendix C:
Declaration of Bona Fides (attached)
Completed and signed Declaration of Bona Fides must be included with this
application.
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Appendix C:
Declaration of Bona Fides
THIS DECLARATION, DULY COMPLETED, MUST BE SUBMITTED BY PRINCIPAL APPLICANT
Name of Project Lead:
Organisation:
Please tick Yes or No as appropriate to the following statements relating to the current status of your organisation
No.
Question
1.
The Principal Applicant is bankrupt or is being wound up or its affairs are being administered by the court or has
entered into an arrangement with creditors or has suspended business activities or is in any analogous situation
arising from a similar procedure under national laws and regulations.
2.
The Principal Applicant is the subject of proceedings for a declaration of bankruptcy, for an order for compulsory
winding up or administration by the court or for an arrangement with creditors or of any other similar proceedings
under national laws and regulations.
3.
The Principal Applicant, a Director or Partner or Co-Applicant, has been convicted of an offence concerning his
professional conduct by a judgment which has the force of res judicata or been guilty of grave professional
misconduct in the course of their business.
The Principal Applicant has not fulfilled its obligations relating to the payment of taxes or social security
contributions in Ireland or any other State in which the tenderer is located.
Y
N
Please 
4.
5.
The Principal Applicant, a Director or Partner or Co-Applicant has been found guilty of fraud.
6.
The Principal Applicant, a Director or Partner or Co-Applicant has been found guilty of money laundering.
7.
The Principal Applicant, a Director or Partner or Co-Applicant has been found guilty of corruption.
8.
The Principal Applicant, a Director or Partner or Co-Applicant has been convicted of being a member of a criminal
organisation.
The Principal Applicant, a Director or Partner or Co-Applicant has been guilty of serious misrepresentation in
providing information to a public buying agency.
The Principal Applicant has contrived to misrepresent any information relevant to this application.
9.
10.
I certify that the information provided above is accurate and complete to the best of my knowledge and belief. I
understand that the provision of inaccurate or misleading information in this declaration may lead to my
organisation being excluded from participation in this and future funding calls.
Signature
Date
Name
Position
Telephone
Email
SFI Discover Programme Science Week Regional Festivals Call 2016 – Application Form
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Checklist
Application Submission Checklist
In order to allow Science Foundation Ireland to fully evaluate completed applications, you should ensure
that the response includes ALL of the following information:
1. Completed Application Form – all applicants must complete Sections A and either Section B or Section C.
2. One page (max) CVs for each of the project team members written with relevance to this project.
Letters of Support from relevant organisations outside of the Project Lead’s organisation. Letters of
support are only required from relevant organisations whose contribution is a key element to the
delivery of the project (Appendix A).
3. Track record in STEM Education and Public Engagement (max 4 pages) (if applicable) (Appendix B)
4. Signed Declaration of Bona Fides (Appendix C)
5. Any relevant corporate / financial information as outlined in Section B (non Eligible Research Bodies)
6. Completed and signed cover sheet – Section C (Eligible Research Bodies)
The above checklist is for guidance purposes only and Science Foundation Ireland will not accept any
responsibility for omissions from this checklist or in application. Applicants are advised to read all the
documentation and appendices in full in order to provide a comprehensive application.