Application for Grant From

APPLICATION FOR GRANT FROM

THE WORKING ENVIRONMENT RESEARCH FUND

(ARBEJDSMILJØFORSKNINGSFONDEN)

(Research and development projects and systematic reviews)

APPLICATION FORM

(Read guide first)

1 / The application pertains to
Research project (check with X) / If PhDscholarships (state number):
Development project or systematic review (check with X)
This is a re-application (check with X) / Date of the first application:
2 / Applicant
DanishCVR
Name:
Address:
Telephone number and
E-mail:
3 / Principle Investigator
Name:
Work address:
Telephone number and
E-mail:
4 / Project title
5 / Amount applied for - for the whole project period
6 / Location(s) where projectis carried out:
Address(es):
Telephone number:
E-mail:
7 / Project duration(no.of months):
Start and end date:
Amount applied for in each calendar year:
month: year: month: year:
1st year:
2nd year:
3rd year:
4th year:
Hasthe applicationbeen submitted to other funding agencies? / NoYes
If yes, how much and when is a reply to be expected?
Has the project received funding from other sources? / NoYes
If yes, state the funding source. Seealso box13
9 / List of the project staff (name, position, work address)
10 / Brief description/summary of the project(Max. 400 words)(see guide)
11 / Publication and communication plan:
12 /

Description of the novelty of the project and the expected impact on the working environment

13 / Projectbudget per calendar year (In casethe project is a collaboration between several institutions, each institution must sign and submit their own sub-budget)
In addition, the applicant must complete a consolidated budget form, which can be downloaded from the web site.
Budget item / From the Fund /

From the applicant

From others

Man-months / DKK / Man-months / DKK / Man-months / DKK
VIP/ACsalary[1]
TAPsalary[2]
Operating costs
overheads
Total 1st year:
VIP/ACsalary
TAPsalary
Operating costs
overheads
Total 2nd year:
VIP/AC salary
TAPsalary
Operating costs
overheads
Total 3rd year:
VIP/ACsalary
TAP salary
Operating costs
overheads
Total 4th year:
Date and signature of the person authorized to sign for the applicant institution:
(The signatory approves the project budget and accepts that the project is carried out at the applicant instiution)
14 /

Other information

15 /

List of enclosed appendices.(See guide for the following appendices to be enclosed:

1. project description, 2.publication and communication plan, 3. detailed budget,4. CV and publicationlist for the principal investigator and other participants in the projectgroup)

16 /

Applicant’s signature and date of application

[1]Academic/professional staff’s salary

[2]Administrative and technical staff’s salary