ASRF Application Form

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Samih Darwazeh Innovation Grant Application Form

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ASRF Application Form

  1. 1. ASRF PROPOSAL APPLICATION FORM Innovation Grant Scheme Revision 6.2, Jan. 2012
  2. 2. TABLE OF CONTENTS 1. Introduction and Funding Conditions........................................................................................................3 2. Cover page..................................................................................................................................................4 Title of the research proposal.......................................................................................................4 Project Acronym............................................................................................................................4 Project summary...........................................................................................................................4 Organization that administers the research grant details..............................................................4 Research team .............................................................................................................................5 Classification of grant proposal / research field............................................................................5 Proposal keywords........................................................................................................................5 Fund and duration summary.........................................................................................................6 Co-funding/ other funding resources.............................................................................................6 3. Concept and objective................................................................................................................................7 Introduction...................................................................................................................................7 Concept / statement of the problem .............................................................................................7 Objectives.....................................................................................................................................7 Expected outcomes......................................................................................................................8 4. State-of-the-art...........................................................................................................................................9 Literature research........................................................................................................................9 Patents research ..........................................................................................................................9 5. Implementation and Methodology...........................................................................................................10 Scientific methodology and experiments.....................................................................................10 Project plan.................................................................................................................................10 Project work packages ...............................................................................................................10 Project milestones.......................................................................................................................11 Project schedule.........................................................................................................................12 Research team............................................................................................................................12 Research team capability statement...........................................................................................13 Facilities, equipment & other resources......................................................................................14 6. Financial requirements and justification..................................................................................................15 Budget 15 Other major financial resources..................................................................................................17 7. Impact and dissemination ........................................................................................................................18 Results dissemination plan.........................................................................................................18 Management of intellectual property...........................................................................................18 Industrial involvement and exploitation of the results..................................................................18 Contribution to community and societal objectives.....................................................................18 8. Ethical issues ...........................................................................................................................................19 9. Certification..............................................................................................................................................20 10. Checklist for submitting the research proposal......................................................................................21 11. Reviewers suggestion.............................................................................................................................22 Proposal Application Form - Rev.6.2 2 / 22
  3. 3. 1. Introduction and Funding Conditions Applied Scientific Research Fund (ASRF) is an Arabic non-government, non-profit organization, created by Samih Darwazah, founder of Hikma Pharmaceuticals, to foster and enable innovation through various funding schemes for applied researches and commercialization activities as well as to create the culture of research and innovation in the Arab region.  Funding scheme objectives: ◦ Support innovative ideas by starting from R&D and focusing on the value of the impact of the results and finally commercialization ◦ Accelerate the commercialization process by moving from the research idea to prototype  Eligibility: ◦ Researchers and inventors ◦ Research centers and universities  Conditions to be a candidate project: ◦ Quality of scientific proposals and contribution to science ◦ Technical feasibility of the project ◦ Market potential and feasibility ◦ Clear, tangible and measurable outcomes ◦ Impact and quality of the prospected results  ASRF’ Support (up to 100,000 JD over 2 years) that can include:: ◦ Material and equipment ◦ Research and implementation cost ◦ Prototype design and development ◦ Full lab-scale demonstration and technical testing ◦ Material and implementation costs ◦ Technical and prototype testing ◦ Conducting field studies  Intellectual Property ownership: ◦ ASRF owns the resulting IP ◦ ASRF and the inventor share royalty from sales/commercialization according the agreement signed between the two parties  Contribution to ASRF and /or the community: ◦ The team agrees to provide technical reports and progress on their project at regular predefined intervals (quarterly every 3-6 months) based on the support/funding agreement. ◦ The team agree to deliver public training/workshops on their technical field of expertise as it relates to the research that is equivalent to 1 day public workshop/training ◦ Agreeing to press and promotion as part of the ASRF marketing and communication campaign, with teams prior approval of content. Proposal Application Form - Rev.6.2 3 / 22
  4. 4. 2. Cover page Title of the research proposal Concise & descriptive title (No more than 20-25 words) Project Acronym Project summary (1 page max) • Include a self-contained description of the activity that would result if the proposal is funded. Include a statement of objectives and methods to be employed. • Summarize project goals and expected outcomes, including how they pertain to broader impacts. • Describe specific goals, methodology, long-term objectives, expected results Organization that administers the research grant details Organization’s Name Division or Department Title & Name of Head/Chairman (Authorized representative of the organization) City Country Address Phone Fax Email of the contact person Website Proposal Application Form - Rev.6.2 4 / 22
  5. 5. Research team Investigator/researcher1 Name Title/Position Institute3 PI (Principle Investigator) Co-I 1 (Co-Investigator) Co-I 2 (Co-Investigator) Co-w1 (Co-worker)2 Co-w2 (Co-worker) Note1: Only PI & Co-I are considered to the IP (Intellectual Property) rights Note2: Co-workers (employees or contractors) may be determined later after the grant/fund is approved. Co-workers are not considered to the IP (Intellectual Property) ownership rights Note3: The PI (Principle Investigator) must be affiliated with the organization that will administer the grant Classification of grant proposal / research field Classify your proposal under each of the following areas. (Multiple fields can be selected but indicate the main field with “M”) Acronym Scientific Area Field Selection AF Agriculture, Food and Fisheries Sciences BT Biotechnology CI Chemical Industries DM Drugs & Medicines EE Electrical & Electronics Technologies EG Energy (including renewable energies) EN Environment, (including Climate Change) HE Healthcare IT Information and Communication Technologies MC Mechanics & Construction NN Nanosciences, nanotechnologies, materials & new production technologies NS Natural / Pure science SE Security and Safety SH Socio-economic Sciences and the Humanities TT Transport & logistics WA Water, Waste & Utilities OT Other: Please specify Indicate research subfields Proposal keywords To facilitate selection of evaluators / indexing / promotion/ etc Proposal Application Form - Rev.6.2 5 / 22
  6. 6. Fund and duration summary Requested Fund amount (in JOD) (10 to up to 100K)1 Project Duration (in Months) (6 to 24 Months)1 Note1: Justification must be provided for requested funds more than 100K JOD or more than 24 Months and will be subject for approval by the fund management and the evaluation committee Co-funding/ other funding resources Is this research proposal co-funded by other agency? If yes please attach the funding agreement and the proposal (will be considered in the evaluation) Proposal Application Form - Rev.6.2 6 / 22
  7. 7. 3. Concept and objective Introduction Provide a basic but thorough introduction to your subject. Don’t expect reviewers to be familiar with your field so you should include clarifying information for your project. Reviewers are an intelligent, yet diverse audience. State your overall vision and motivating rationale. What is lacking? Provide background and need/significance. Do you have preliminary results? (one page max) Concept / statement of the problem • State the problem that you are trying to solve • State limitations of existing/current solutions and how such problems are solved or worked around with existing technologies * Be sure to cite any references mentioned in the Project Description. (Two pages max) Objectives State main objective of the proposed research and its significance (One page max) Proposal Application Form - Rev.6.2 7 / 22
  8. 8. Expected outcomes (DISCUSS ALL FOLLOWING 5 POINTS) • Research project outcome (Provide specific, measurable outcomes) • Novelty and innovation (Explain any new features or approaches in your research work) • Beneficiaries of the results and how they might utilize the results. (Avoid the obvious general benefits and focus on specific, measurable benefits) • Prospects for a commercial potential. (New applied ideas, new technologies, new applications, prototypes, startups, etc.) • Patents and papers (Four pages max) Proposal Application Form - Rev.6.2 8 / 22
  9. 9. 4. State-of-the-art Literature research • State cites references related to this project • Critically analyze relevant and recent literature with a point of view of defining what has been done and what is needed (two pages max) Patents research State published patents related to this project (You can use the following links for patents search) • http://www.google.com/patents • http://www.wipo.int/pctdb/en/ • http://www.epo.org/searching.html • http://ipco-jo.org (one page max) Proposal Application Form - Rev.6.2 9 / 22
  10. 10. 5. Implementation and Methodology Scientific methodology and experiments Explain the scientific methodology and suggested experiments and procedure (two pages max) Project plan • Describe on a high level the followings: (more details in next section) • Describe the project Activities and its relation and effectiveness in achieving the project goals. • Describe the time plan • What facilities and resources are available and how they are going to be used? • Include for each Objective of the project: (1) Methods/Activities (2) Expected Results/Deliverables (3) Limitations & alternatives & (4) Timeline/Resources if needed Project work packages Organize the activities to achieve the project in work packages with clear description, actions, durations and expected deliverables. Link the work packages to project objectives (THIS SECTION WILL BE UPDATED, CONSIDERED AND ATTACHED TO THE FUNDING AGREEMENT) Work Package Title Duration (months) Expected End Date WP1 WP2 WP3 Proposal Application Form - Rev.6.2 10 / 22
  11. 11. Work Packages Description1 Work package no. Work package title Expected Starting date WP Duration Researcher No. PI Co- I1 Co- I2 Co- I3 Co- w1 Co- w2 Co- w3 Person-months per researcher2 Objectives Description of activities (possibly broken down into tasks) and role of partners Deliverables and expected outcomes Note1: Include separate table for each work package Note2: If a researcher is not participating in this work package add 0 under his/her number Project milestones (THIS SECTION WILL BE UPDATED, CONSIDERED AND ATTACHED TO THE FUNDING AGREEMENT) Milestone no. Milestone name WPs involved Expected date1 M1 M2 Note1: Researchers will be compensated upon completion of each milestone Milestone no. Means of verification1 M1 M2 Note1: Describe how the milestone achievement will be measured or verified (for example, achieved certain tests, delivery of prototype, buying equipment, etc.). Should be measurable to be included in the grant contract Proposal Application Form - Rev.6.2 11 / 22
  12. 12. Project schedule Start date and duration Proposed start date Duration of the project in months Timeline Work Package Months 2 4 6 8 10 12 14 16 18 20 22 24 WP1 WP2 WP3 Research team (THIS SECTION WILL BE ATTACHED TO THE FUNDING AGREEMENT) Principal & co-investigators summary Principal Investigator (PI) Details Title and Position First Name Last Name Organization Division or Department Address Mobile Phone Fax Email Web Co- Investigator 1 Details1 Proposal Application Form - Rev.6.2 12 / 22
  13. 13. Title and Position First Name Last Name Organization Division or Department Address Mobile Phone Fax Email Web Note1: Include table for each Co-Investigator and co-worker if known Note2: Co-workers are employees/contractors and do not share the IP ownership Research team capability statement • Describe the competencies and skills of the research team why they are suitable for the project and can achieve it. • What are Previous researches conducted by the investigator(s) in the project proposal field • What are their publications and patents in this field, Provide most significant and recent publications, fellowships/contracts awarded, papers presented • What other/previous research projects the team members have managed • Please attach the CVs of the research team (4 pages max for the whole team) PI: Co-I1: Co-I2: Proposal Application Form - Rev.6.2 13 / 22
  14. 14. Facilities, equipment & other resources Describe the facilities, labs, tools and equipment to be used in the project Equipment Code Equipment Name Location1,3,4 Accessibility2,3 Cost of use Eq1 Eq2 Note1: Where is this equipment physically located in the country of research (which institute, department, etc.). Note2: Are there any specific accessibility conditions or requirements Note3: If the equipment is not available in the country of research indicate that Note4: If the equipment is located in the institute that administers the grant will be part of the institute participation in the project Equipment Code Time of use1 Justification of use2 Note1: For how long this equipment will be used Note2: Why this equipment is needed for the project Proposal Application Form - Rev.6.2 14 / 22
  15. 15. 6. Financial requirements and justification Budget Provide detailed budget for first 12 months and estimates for all following years (submit detailed budget each year) Budget summary Item Amount Year 1 Amount Year 2 Note Equipment Human Resources (manpower) Travel * only to access equipment, facilities or do some tests outside the research location Dissemination (Patents, etc.) * papers/conferences are not covered Material / Consumables Services Manpower expenses (SUBJECT TO APPROVAL AND SPECIAL CONDITIONS MIGHT APPLY IN THE GRANT AGREEMENT) Position No. Monthly Rate (MR) Duration of Involvement in months (DOI) % of Full Time subtotal Cost JOD (No x MR x DOI x %) Research assistant Total Proposal Application Form - Rev.6.2 15 / 22
  16. 16. Travel expenses (EACH TRIP MUST BE DIRECTLY APPROVED BY THE FUND MANAGEMENT 90 DAYS BEFORE THE TRAVEL) To From Purpose of travel days Ticket Daily Lodging Subtotal Total Travel Expenses Consumables expenses Description Qty. Unit (kg. m, pack, …) Unit Price Subtotal Total Equipment cost (SPECIAL CONDITIONS IN THE GRANT AGREEMENT MIGHT APPLY FOR PURCHASING THE EQUIPMENT) Equipment code Country of Origin Delivery Time Qty. Unit Price Import duty Tax Subtotal Eq.1 Total Services/facilities give details of needed facilities Description Proposed Usage Cost Total Other items (e.g. dissemination) Proposal Application Form - Rev.6.2 16 / 22
  17. 17. Description and Justification Cost Total Other major financial resources Support for this Projects from other sources Funding Agency Amount in cash Amount in kind Funded activities Please provide the followings: (COPIES OF ALL DOCUMENTS MUST BE ATTACHED) • Funding agreement(s) and proposal(s) • IP ownership of the results • Stage of development / progress • Research results reports Proposal Application Form - Rev.6.2 17 / 22
  18. 18. 7. Impact and dissemination Results dissemination plan How will results be broadly conveyed? Patents, spin-off companies, papers, special seminars, etc. (two pages max) Management of intellectual property How the results will be protected, managed and shared among team, institutes and funders (one page max) Industrial involvement and exploitation of the results How will you exploit the results, who might be interested (industry, companies, institutes, etc.) in the results and do you have clear plan how to involve the industry (one page max) Contribution to community and societal objectives Describe how the results of the project will have impact on some or all of the followings • Quality of life • Health and safety • Employment • Environment (two pages max) Proposal Application Form - Rev.6.2 18 / 22
  19. 19. 8. Ethical issues Please complete the form “04 Ethics Checklist.docx” Proposal Application Form - Rev.6.2 19 / 22
  20. 20. 9. Certification In submitting this research proposal, we confirm on behalf of the Administrative Authority of the submitting organization(s) and partner organizations that: • The information in the proposal submitted is true and complete. • The proposal idea is original and the result of intellectual activities of the PI and Co-Is • The research is scientifically applicable and has potential for industrial application • The Team (PI & Co-Is) are responsible for the delivery of the stated work packages, milestones and the expected results • The team is responsible to report the achievements and resulted IPs to the granting institute Name Signature Date Principal Investigator Person in Charge of Authorizing Organization as Host for Project Co-Investigator 1 Co-Investigator 2 Co-Investigator 3 Proposal Application Form - Rev.6.2 20 / 22
  21. 21. 10. Checklist for submitting the research proposal Item Yes No Cover Page Concept and objective State-of-the art Implementation and methodology Financial requirements and justification Impact and Dissemination Ethical Issues Certification Not exceeded the page limitation Co-funding documents attached Proposal Application Form - Rev.6.2 21 / 22
  22. 22. 11. Reviewers suggestion Could you please suggest 3 referees, reviewers or experts in the field of your research to consult for the assessment? Name Organization’s Name Division or Department City Country Address Mobile Phone Fax Email Website Name Organization’s Name Division or Department City Country Address Mobile Phone Fax Email Website Name Organization’s Name Division or Department City Country Address Mobile Phone Fax Email Website Applied Scientific Research Fund (ASRF)  Email: info@asrf.jo  Tel: +962-6-515-5095  Fax: +962-6-516-1399 Proposal Application Form - Rev.6.2 22 / 22

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