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APPLICATION FOR A JOINT RESEARCH GRANT UNDER THE NRF/JSTAGREEMENT ON COOPERATION IN SCIENCE AND TECHNOLOGY

PART I: GENERAL INFORMATION

Title of Joint Activity:
ActivityStart Date: / Activity End Date:
Discipline:
2012 / 2012/13 / 2013/14 / 2015 / TOTAL
Overall Budget Distribution in South African side(ZAR):
FY 2012 / FY 2013 / FY 2014 / FY 2015 / TOTAL
Overall Budget Distribution in Japanese side(JPY):

Names, Addresses and Affiliations of Principal Investigators

South Africa / Japan
Full name:
Title:
University/Institution:
Dept./Faculty:
Address:
Telephone No.:
Fax No.:
E-mail:
Race (SA only)
Gender (SA only)
ID Number (SA only)

SUMMARY OF JOINT RESEARCH

A brief abstract should be written in the space below, describing the work of both partners (Japaneseand South African) in such a way as to be comprehensible to a non-specialist in the research field. Applications should briefly describe: 1. Objectives; 2. Methodology; 3. Significance of the proposed activity; 4. Mode of co-operation; 5. Anticipated outputs;6. Scientific and technological background and 7. Possible socioeconomic benefits. (Extend space where required)

Names and affiliations of other South Africanresearchers/studentsto participate in the activity (add rows where required)

Full name / Current Academic Qualification / Institution (State if student or researcher) / Race & Gender

Signatures (All copies submitted should contain the signature of the submitting Principal Investigator and the Research Authorising Officer of his/her institution.

Principal Investigator Name:
Position:
Signature: / Date:
Research Authorising Officer Name:
Signature: / Date:
Japanese Partner’s Name:
Position:
Signature: / Date:

Names and affiliations of other Japanese researchers/students to participate in the activity (add rows where required)

Full name / Current Academic Qualification / Institution (State if student or researcher) / Race & Gender
(N/A)

PART II - DETAILED DESCRIPTION OF THE ACTIVITY

A full technical description of the activity should be included here or submitted on separate pages.
The following are suggested headings for this section:
  1. Detailed description of the activity.
  1. Discussion of the scientific and technological background (including references and the relationship to previous research activities relating to the present proposal).
  1. Specific objectives and expected significance of the activity.
  1. Methodology and plan of work. The respective roles of the co-operating partners in carrying out the proposed activity should be indicated.
5. Record of preliminary results relevant to the proposal.
Detailed account of available resources including all personnel and equipment.
6. Mode of co-operation between the Japanese and South African teams.
7. Bibliography relevant to the research area.
8. Possible socioeconomic benefits to the country.
Note: Items 1 to 8 should be limited to a maximum of 10 pages.

PART III - TIME SCHEDULE AND WORK PLAN

Please outline the specific activities planned by the Japanese and South African investigators for the total period of the activity (extend space where required)

Research Activity / Location of Research Activity / Proposed Duration
Institution / Country / Start / End
Month / Year / Month / Year
Explanatory Remarks

PART IV - BUDGET DESCRIPTION

Instructions:
Separate budgets should be prepared for the Japanese and South African sides of the activity.

1. BUDGET DETAILS FOR SOUTH AFRICAN FUNDING (in Rand)

Travel, accommodation and subsistence allowance (add rows where required)

Description
1st Year / 2nd Year / 3rd Year
Airfare (SA researchers):
Accommodation (Japanese researchers):
Subsistence (Japanese researchers - Amount per day & Number of Days):
TOTAL

Costs for joint conferences and workshops (where applicable – add rows where required))

Item Description / Cost

TOTAL

2. BUDGET FOR THE WHOLE ACTIVITY (JAPANESEAND SOUTH AFRICAN) IN RANDS

Japanese Side

1st Year / 2nd Year / 3rd Year
Travel, accommodation and subsistence allowance:
Conference/Workshop:
Other (please specify):
TOTAL

South African Side

1st Year / 2nd Year / 3rd Year
Travel, accommodation and subsistence allowance:
Conference/Workshop:
Other (please specify):
TOTAL

3. OTHER SOURCES OF SUPPORT

3.1Is this activity currently being supported by other sources?

YES / NO

If yes, please indicate the sources, amounts and periods of support.

Japaneseside:

South African side:

3.2Has this proposal been submitted to other agencies for financial support?

YES / NO

If yes, please indicate which agencies, and when.

Japaneseside:

South African side:

PART V - BIOGRAPHICAL AND PROFESSIONAL INFORMATION

1.Principal Investigator - Japanese

This resume concerns the JapanesePrincipal Investigator whose name appears in Part 1.

Title
First Names
Family Name
Nationality
Year of Birth

Resume (Relevance of the researcher’s professional background to the proposed activity).

In addition, please enclose an abbreviated Curriculum Vitae, which should include the following:

1.Academic and professional training, including names of institutions, years of study, degrees and diplomas.

2.Academic and professional experience, including names of institutes and companies, role and period.

3.Research areas (detailed areas of research in which the researcher has been involved).

4.Publications and patents (during last two years).

5.Any additional detail which may assist in evaluating the professional background of the researcher.

2.Principal Investigator - South Africa

This resume concerns the Principal South African Investigator whose name appears in Part 1.

Title
First Names
Family Name
Nationality
Year of Birth

Resume (Relevance of the researcher’s professional background to the proposed activity).

In addition, please enclose abbreviated Curriculum Vitae, which should include the following:

1.Academic and professional training, including names of institutions, years of study, degrees and diplomas.

2.Academic and professional experience, including names of institutes and companies, role and period.

3.Research areas (detailed areas of research in which the researcher has been involved).

4.Publications and patents (during last two years).

5.Any additional detail which may assist in evaluating the professional background of the researcher.

平成24年度 日本－南アフリカ

戦略的国際科学技術協力推進事業

申請様式

研究交流分野

国際研究交流の研究題名

日本側研究代表者

南ア側研究代表者

国際研究交流の研究期間

日本側の総費用

要旨

提案の簡潔な要旨（2ページ目の和訳）を以下にお書きください。要旨には日本側と南ア側双方の研究内容について、専門分野外の方にも分かるようにお書きください。研究の1．目的、2．方法、3．提案内容の優れている点、4．協力の方法、5．期待される成果、6．科学的、技術的な背景、7．可能性のある社会・経済的利益についても簡潔に記載してください。

経費計画 （日本側にかかる経費のみをご記入ください。）

＜総額 千円＞ 総額は1500万円を越えないように記入してください。

（単位：円）

費目 / 平成24年度 / 平成25年度 / 平成26年度 / 平成27年度
直接経費 / 物品費
人件費・謝金
旅費
会議費
その他
小計
間接経費
（直接経費×10％以下）
合計
（直接経費＋間接経費）

（注：年度は会計年度となります。表の項目追加が必要な場合は、追加して下さい。

なお、採択された場合は、予算との関係で支出金額については調整させていただきます。）