Ampera Funding Initiative

AMPERA FUNDING INITIATIVE

TRANSNATIONAL CALL FOR PROPOSALS 2007

FULL PROPOSAL APPLICATION FORM

for a collaborative project

Project title

Project Acronym

I. Administrative details and project summary

Applicant/ Coordinator – Partner 1

Research institute/ Company
Status: Private or public?
Street name and number
Head of institution / E-mail:
PO Box / Postal code / Cedex
Town / Country
Signature of the Head of institution: / Date
Researcher in charge [CV of 2-3 pages to be included in Annex III]

Family name

/ First name(s)

Title

Gender

/ Female  / Male 

Date of birth

(DD/MM/YYYY)

Nationality

Phone / Fax
E-mail
Web site
Key personnel (list) [CV of 2-3 pages to be included in Annex III]

Applicant – Partner 2

Research institute/ Company
Status: Private or public?
Head of institution / E-mail:
Street name and number
PO Box / Postal code / Cedex
Town / Country
Signature of the Head of institution: / Date
Researcher in charge [CV of 2-3 pages to be included in Annex III]

Family name

/ First name(s)

Title

Gender

/ Female  / Male 

Date of birth

(DD/MM/YYYY)

Nationality

Phone / Fax
E-mail
Web site
Key personnel (list) [CV of 2-3 pages to be included in Annex III]

Applicant – Partner 3

Research institute/ Company
Status: Private or public?
Head of institution / E-mail:
Street name and number
PO Box / Postal code / Cedex
Town / Country
Signature of the Head of institution: / Date
Researcher in charge [CV of 2-3 pages to be included in Annex III]

Family name

/ First name(s)

Title

Gender

/ Female  / Male 

Date of birth

(DD/MM/YYYY)

Nationality

Phone / Fax
E-mail
Web site
Key personnel (list) [CV of 2-3 pages to be included in Annex III]

Applicant – Partner 4

Family name

/ First name(s)

Title

Gender

/ Female  / Male 

Date of birth

(DD/MM/YYYY)

Nationality

Phone / Fax
E-mail
Web site
Key personnel (list) [CV of 2-3 pages to be included in Annex III]

Applicant – Partner 5

Family name

/ First name(s)

Title

Gender

/ Female  / Male 

Date of birth

(DD/MM/YYYY)

Nationality

Phone / Fax
E-mail
Web site
Key personnel (list) [CV of 2-3 pages to be included in Annex III]

Please make copies of the table above if there are more applicants

Summary

(Please describe briefly objectives, work planning and expected exploitation of results of the suggested collaborative project, max. 2 pages)

Work packages (WP)

No. of WP / Title
1
2
3
4
5
N

(Use as much lines as needed)

Milestones

No. / Title
1
2
3
4
5
N

(Use as much lines as needed)

Deliverables

No. / Title
1
2
3
4
5
N

(Use as much lines as needed)

Application Form 1/9

AMPERA FUNDING INITIATIVE

TRANSNATIONAL CALL FOR PROPOSALS 2007

Estimated person months per work package and task

WP 1 / WP 2 / WP 3 / WP 4 / WP N / Total
1.1 / 1.2 / 1.3 / 1.4 / 1.5 / 2.1 / 2.2 / 2.3 / 2.4 / 2.5 / 3.1 / 3.2 / 3.3 / 3.4 / 3.5 / 4.1 / 4.2 / 4.3 / 4.4 / 4.5
Partner 1 :
Researcher in charge
Key personnel
Partner 2 :
Researcher in charge
Key personnel
Partner 3 :
Researcher in charge
Key personnel
Partner 4 :
Researcher in charge
Key personnel
Partner N :
Researcher in charge
Key personnel
Total

(Use as much lines and columns as needed)

Application Form 1/9

AMPERA FUNDING INITIATIVE

TRANSNATIONAL CALL FOR PROPOSALS 2007

Costs per partner and requested funding budget (in EURO)

Partner / A - Total costs/expenses1) / B - Requested funding budget / Funding rate (B/A)
Partner 1 / %
Partner 2 / %
Partner 3 / %
Partner 4 / %
Partner 5 / %
Partner N / %
Total

1) Total costs/expenses comprise costs or expenses for personnel, travelling, consumables, overhead (if applicable) etc.; the cost calculation has to be based for each partner on its national/regional funding rules; for questions, please contact your national/regional funding organisation

(Use as much lines as needed)

Duration of the project:

DD/MM/YYYY - DD/MM/YYYY

Breakdown of costs per partner (in EURO) per year

Salaries / Travelling / Overheads / Consumables / Equipment / Total
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
Partner N
Total

(Use as much tables as needed)

II. Project description

Please provide a detailed project description, jointly filled by all applicants, which addresses:

Recommended No. of pages
1. / Title of proposal
2. / General information on the
1.Coordinator
2.Partners involved / 2
3. / Evidence of special competence and references from the applicants and, where applicable, description of the partners preliminary work and results relevant for the proposals (including current AMP research projects) / 3
4. / Project description
1.Scientific objectives with detailed account of their relationship to the themes of the call and to current European AMP research activities
2.Work plan and division of work packages between the partners
3.Proposed exploitation of future project results
4.Dissemination of results to practitioners and policy / 15
(1-2)
(10-12)
(1-2)
(1)
5. / Detailed work and time schedule / 1
6. / Sharing of work and cooperation with external organisations contributing to the project (if applicable) / 1
7. / Survey of the collaborative project financing scheme indicating by partner the applicants own funds and financial requirements, structured according to permissible expenditure/cost types. / 1
8. / Description of project management / 2
9 / In case of associated partner: signed document from the ‘third’ funding institution (as proof for own funding) / 1

III. Annex: CVs

Please attach below short CV (2-3 pages) for each co-applicant Researcher in charge and listed key personnel.

Application Form 1/9