/ Receipt date
CSA Class Grant and Contribution Program to Support
Research, Awareness and Learning in Space Science and Technology
Application Form
Space Exploration
Science Definition Studies
Announcement of Opportunity / Application #
(Reserved for internal use)

Notice to Applicants:Please read the Canadian Space Agency (CSA) Class Grant and Contribution Program Overview and the Space Exploration Science Definition Studies Announcement of Opportunity description. Enter answers in all fields as indicated. Your application may not be considered if it is incomplete. It is the applicant’s responsibility to ensure that the application complies with all relevant federal, provincial and territorial legislation and municipal bylaws. Please do not change the formatting. Fill out the form using an Arial 10-point font. Save the form as an MS Word file (.doc). Handwritten forms will not be accepted.

SECTION 1 –APPLICANT INFORMATION
Legal name of the organization (must be confirmed by the Office of Research)
Full name of Principal Investigator(PI) / Full name of Representative from theOffice of Research
Title/Position / Title/Position
Address / Address
Telephone / Fax / Telephone / Fax
Email / Email
Preferred language for correspondence  Français English
SECTION 2–PROJECT SUMMARY
Proposal title:
Amount requested from the CSA per government fiscal year (April 1 to March 31) / Total Project Budget
(CSA + Other)
Year 1 / Year 2 (if extended) / Total (2 years)
SECTION 3 – SIGNATURES
Signature of Principal InvestigatorDate / Full name of duly authorized signatory
Title/Position
Applicants must mail one (1)paper copy of the proposalwith original signatures and an identical electronic copy of the proposal saved in a standard media format (USB key, CD or DVD)to:
SE Science Definition Study 2016 AO
c/o Dr. Victoria Hipkin
Space Exploration Development
Canadian Space Agency
6767 Route de l’Aéroport
Saint-Hubert, Quebec J3Y 8Y9 / Telephone / Fax
Email
I declare that I am the duly authorized signatory for the organization.
SignatureDate
The information collected on this form and appendices will be stored in the Personnel Information Bank of the CSA Grant & Contribution Program to Support Research, Awareness and Learning in Space Science and Technology.
PROTECTED WHEN COMPLETED / Version françaisedisponible
/ Page 1
CSA Class Grant and Contribution Program to Support
Research, Awareness and Learning in Space Science and Technology
Application Form –SE SDS AO
SECTION 4 –ELIGIBILITY CRITERIA
The following five (5)criteria will be used by the CSA to pre-screen the applications. Each criterion MUST have at least one box checked off and/or the required information provided. Applications that fail to meet one or more criteria will be deemed non-compliant and will not be assessed further. Please checkall applicable boxes.
  1. Canadian university (see SDS AO Section 3.1):
Yes
No /
  1. Link to Priority Research Area (see SDS AO Section 3.3)
Mars Sample Return Sample Analysis Approaches
  1. Eligible Projects
Fieldwork at analogue sites
Analysis of planetary or astrophysical data
Analysis of astromaterials
Laboratory research
Modelling and simulations
Instrument breadboarding
Other research activities as relevant to the research priority /
  1. Link to Class G&C Program
To support the development of science and technology relevant to the priorities of the Canadian Space Agency
To foster the continuing development of a critical mass of researchers and highly qualified people in Canada in areas relevant to the priorities of the Canadian Space Agency
Number of HQP from Canadian universities: ______
  1. Budget requested from the CSA
Complies with maximum funding per project per year described in SE SDS AO Section 6.1, Table 3
Funding requested per year is ______/ For CSA use only: Result of pre-screening
Compliant
Non-compliant
SECTION 5 – PROJECT DETAILS
Please provide a short summary (maximum of 100 words) of the proposal using non-technical language for public releasein case your proposal is accepted.
Please describe the project using keywords (maximum of 10) separated by semicolons.
Detailed Project Description
Please attach a detailed description of the proposed research project, including objectives, methodology, schedule and budget. Please structure this section with subheadings corresponding to the applicable evaluation criteria.
The cover page of the attachment must contain the title of the proposal, the name of the principal investigator and the legal name of the organization requesting the grant. Please limit the document to a maximum of 20 pages in a commonly used format (.doc, .docx, .pdf, .rtf, or .txt), and use a 10-point Arial font, on 8.5x11paperwith 1" margins, excluding reference pages. Figures are welcome as long as they are embedded in the text. Appropriate references should be listed at the end of the project description.
1. INTRODUCTION
Provide a brief description of your project and how it links to the Priority Research Area identified in the AO, addressing all elements requested in the Priority Research Area description.
2. PROPOSED RESEARCH PROJECT
Note: Applicants should carefully read all selection criteria and provide the requested information for each of them.
2.1 BENEFITS FOR CANADA
2.1.1Advancement of scientific knowledge relevant to the CSA Exploration Program
Describe how the investigation fully addresses the science objectives identified in the Priority Research Area and how the probable results have a broad, long-term impact beyond the immediate field of study. Describe how the proposal is distinguished by highly novel or original concepts or methods, builds on recent Canadian research advances, and is likely to significantly enhance the reputation of Canada in the Priority Research Area. Provide support through references to the literature.
2.2 RESULTS
2.2.1Publication and science dissemination plan
Provide a plan to disseminate results from the project. Discuss how this plan could raise Canada’s profile in the Priority Research Area.
2.2.2Enhancement of pool of space experts
List the names of students and HQP involved in the project and how the project will benefit their training and career development.
2.3 RESOURCES
2.3.1 Quality and experience of the PI and investigation team
List the names of the core team of investigators involved, and describe their expertise and track records in conducting similar research projects with reference to their role in this project. Provide a rationale for the team’s composition and describe how it has the necessary expertise for the successful implementation of the project. Discuss previous experience in space science missions.

2.4 FEASIBILITY OF THE PROJECT

2.4.1 Research plan, schedule and budget
Describe the project research planfor Year1 including a schedule oftasks with associated schedule milestones and clearly specified roles and responsibilities and time allocations for each project team member. Provide a detailed description of each task. For travel items, ensure the people travelling are clearly identified where possible, and convincing rationale for their travel is provided. Indicate how project plan aligns with any requirements in the Priority Research Area, as applicable.
Note that a detailed schedule and budget are requested as attachments in Sections 7 and 8 respectively.
Describe the project research plan for Year2, should the funding be available and the project be extended.
2.4.2 Access to other funding and resources
Describe inkind contributions provided to this project from team members, how they contribute to the success of the project, and quantify their value. Describe any funds from other organizations (Canadian or foreign)and how these contribute to the success of the project. Indicate whether such funds are confirmed or pending.
2.5 RISK AND MITIGATION STRATEGIES
2.5.1 Project risks (financial, managerial, environmental and technical) and mitigation strategies
Provide a thorough analysis of the key risks associated with the project and the mitigation strategies for each risk. Specifically, describe the financial, technical, managerial and environmental risks and state the probability of the risks materializing. If this is collaborative research involving multiple organizations (Canadian or foreign researchers), are contributions and resources well understood?
SECTION 6 – TEAM MEMBERS (PRINCIPAL INVESTIGATOR, CO-INVESTIGATORS)
In the following, please provide the names and contact information of the team members.Attach an additional sheet if needed.Please include with the application a standard or professional CV for each member of the team.
Team Member 1
Full Name / Email
Title/Position / Telephone / Number of HQP to be supervised:
Organization / Role in the project
Team Member 2
Full Name / Email
Title/Position / Telephone / Number of HQP to be supervised:
Organization / Role in the project
Team Member 3
Full Name / Email
Title/Position / Telephone / Number of HQP to be supervised:
Organization / Role in the project
Team Member 4
Full Name / Email
Title/Position / Telephone / Number of HQP to be supervised:
Organization / Role in the project
Team Member 5
Full Name / Email
Title/Position / Telephone / Number of HQP to be supervised:
Organization / Role in the project
SECTION 7– DETAILED IMPLEMENTATION SCHEDULE
Please attach a detailed implementation schedule for the project. The CSA recommends presenting the schedule in both a Gantt Chart and a tabular format with the following column headings: Work Breakdown Structure (WBS) identifiers (e.g. 1.1.2); task name; task duration; start date; completion date; task dependencies (predecessor and successor task identifiers, relationship type, and lead or lag durations); and assigned leads for main task groups.
SECTION 8– DETAILED BUDGET AND SOURCES OF FUNDING
Please provide a detailed, itemized budget indicating all sources of funding for the project and project expenditures.
-Information should be broken down per government fiscal year (April 1 to March 31);
-All funding sources and all expenditures must be included, and identified as cash or in-kind;
-For each expenditure, the source of funding (or in-kind contribution), the total amount(s), and the breakdown by source of funding must be provided.
Please refer to Section 6.2 of the SDS AO for a list of eligible costs.
Budget Breakdown ($)
Budget
Category / Description
and Details / Amount Requested from the CSA / Total Amount Requested from Other Sources / Total Project Budget
(CSA + Other)
Year 1
(April 1 to March 31) / Year 2 extension
(April 1 to March 31, subject to CSA funding availability)
Access fees
Accommodation and meal allowances
Acquisition, development and printing of materials
Acquisition or rental of equipment (a maximum of 30% of the grant for laboratory instruments)
Bursaries
Consultant services
Costs for carrying out environmental screening and/or impact studies
Costs related to obtaining security clearance
Data acquisition
Data management
Laboratory analysis services
Licence and permit fees
Marketing and printing services
Materials and supplies
Participation fees at conferences, committees and events
Publication and communications services
Registration fees
Salaries and benefits
Training
Translation services
Travel
Other expenses (not supported by the CSA)
TOTAL before overhead
Overhead (university administrative) costs (not to exceed 10% of CSA requested grant)
TOTAL
SECTION 8– DETAILED BUDGET AND SOURCES OF FUNDING (continued)
Using the information in the detailed budget, please identify any current and/or proposed funding sources.
Source of Funding
(Name of Funding Organization and its Funding Program) / Contact Person
(Full Name, Title and Telephone Number) / Type of Funding (Inkind, Grants, etc.) / Funding Amount
($) / % of Total Project Budget / Confirmed Funding?
(YES/NO)
SECTION 9 – SUGGESTED REVIEWERS
Please identify suggested reviewers for this proposal.
Full Name / Organization / Telephone / Email
SECTION 10 – OTHER
Please provide other documents to support your proposal such as a proposal related to the project you would have already presented to NSERC or other funding organizations as well as letters of support from each co-investigator listed and letters of intent from organizations providing other sources of funding or in-kind contributions.
The information collected on this form and appendices will be stored in the Personnel Information Bank of the CSA Grant & Contribution Program to Support Research, Awareness and Learning in Space Science and Technology.
PROTECTED WHEN COMPLETED / Version françaisedisponible
/ Page 1
CSA Class Grant and Contribution Program to Support
Research, Awareness and Learning in Space Science and Technology
Application Form –SE SDS AO

Applicant Declaration on Confidentiality, Access to Information Act and Privacy Act

The applicant, through itsduly authorized representative signing below, certifies as follows:

1.The applicant authorizes the Canadian Space Agency (CSA) to share this application (including supporting material) with other federal and provincial government sources of assistance in order to facilitate cooperation between the CSA and other federal departments and provincial governments for the purposes of the applicant’s application for such assistance, as well as to review and assess applications to ensure that there is no duplication of assistance and to confirm compliance with all agreements. The applicant also authorizes the CSA to gather the necessary information for such purposesfrom other federal departments and provincial governments.

2.Any relevant authorizations from individuals and other third parties have been obtained.

3.Necessary measures have been taken to protect the confidentiality of the information provided by the applicant. This information is collected under the authority of the CSA Class Grant and Contribution Program to Support Research, Awareness and Learning in Space Science and Technology – Research Component, and will be used for the evaluation and selection ofproposals. Personal information (such as contact information and biographical information) included in rejected proposals will be stored in a CSA Personal Information Bank for five(5) years and then destroyed (Information Bank to be registered with the Treasury Board of Canada Secretariat soon). Personal information included in successful proposals will be kept along with the proposal results for historical purposes. These data are protected under the Privacy Act. According to thePrivacy Act, the data associated with an individual and included in the proposal being evaluated can be accessed by the specific concernedindividualwho has rights with respect to this information. This individual may, upon request, (1) be given access to his/her data, and (2) have incorrect information corrected or have a notation attached.

4.The applicant understands that the information provided in this application (including supporting material) is subject to the federal Access to Information Act and Privacy Act.

I certify that I have read and clearly understand the above information and that the representation made herein is true and accurate.

Signature / Date
Duly authorized representative (typed name and title)

Supporting Documentation Form (for Organizations in Quebec)

Relative to ChapterM-30 of the

Actrespecting the ministère du Conseil exécutif, R.S.Q., c. M-30.

Please review the relevant provisions of the Act, complete this form, have it signed by the duly authorized representative, and return it to the CSA along with all the required supporting documents in your application.

Project Title
Legal Name of Entity/Organization
1) Under Section3.11, is the applicant (proposed payee) a municipal body or schoolbodywithin the meaning of Section 3.6.2 of the Act? / Yes / No
2) Under Section3.12, is the applicant (proposed payee) a public agencyas defined by Section3.6.2 of the Act? / Yes / No
3) If there is a signed agreement between the applicant and the CSA, will the agreement affect a government agency, municipal body, school body or public agency within the meaning of the Act? / Yes / No
If you answered “Yes” to any of the above questions, you must:
  • Obtain authorization from the Secrétariat aux affaires intergouvernementalescanadiennes of the Quebec government before signing the funding agreement; and
  • Provide a copy of this authorization along with your application.
/ /
If you answered “No” to all three questions, please submit this form, signed by the duly authorized signatory, with your application and any appropriate supporting documents.
I certify that I have read and clearly understand the above information and that the representation made herein is true and accurate.
Signature / Date
Duly authorized representative (typed name and title)
The information collected on this form and appendices will be stored in the Personnel Information Bank of the CSA Grant & Contribution Program to Support Research, Awareness and Learning in Space Science and Technology.
PROTECTED WHEN COMPLETED / Version françaisedisponible
/ Page 1