350 Research Grants - Application Form
Please send completed form to
This application refers to the following Challenge:☐The next game changing molecule or technology to helpfight cancer or autoimmune disease
☐The next generation production technology for biologics
☐Revolutionizing microbiome research
☐The next generation of intelligent material
☐Characterization, control and surface chemistry
☐Atomic layer processes – from modelling to materials
☐How can in-silico research benefit from deep learning or quantum computing
Personal Data of the applicant
Surname / Click or tap here to enter text. / Address
(office address representing the entity, which shall receive the funding (e.g. the institute,) / Building & Street / Click or tap here to enter text. /
ZIP / Click or tap here to enter text. /
First Name / Click or tap here to enter text. / City / Click or tap here to enter text. /
Country / Click or tap here to enter text. /
Name of Institute / Entity / Company / Start-up the proponent is affiliated to / Click or tap here to enter text. / Add address if different from above / Building & Street / Click or tap here to enter text. /
ZIP / Click or tap here to enter text. /
City / Click or tap here to enter text. /
Country / Click or tap here to enter text. /
Name and Place of research (where the research described below will be performed) / Click or tap here to enter text. / Add address if different from above
- / Building & Street / Click or tap here to enter text. /
ZIP / Click or tap here to enter text. /
City / Click or tap here to enter text. /
Country / Click or tap here to enter text. /
Research Proposal
Title / Click or tap here to enter text.
Short abstract
(limit 100 words) / Click or tap here to enter text.
Research Proposal
PROVIDE ONLY NON-CONFIDENTIAL INFORMATION
Objective of the research
(e.g. what is the scientific question and rational;
limit 150 words)
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Impact of the objective / expected results
(e.g. why is this research important; references can be used if relevant; limit 400 words)
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Description of the research(which experiments are planned to address the objective of the project, rationale why these experiments are planned and not other options (if there are any;
limit 1000 words, you may want to add figures, graphs etc.)
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References for the research
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Other relevant information
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Terms and conditions
Confirmation on the correctness of the information / I, the applicant, herewith confirm that the information stated on this form is correct and to the best of my knowledge. / ☐Yes
☐No
Entitlement to request the Grant / I, the applicant, herewith confirm that I am entitled to request and obtain the350 Research Grant funding without violating any requirements of my employer / institute or any other existing obligation and to have obtained all necessary employer approvals. / ☐Yes
☐No
☐N/A
Confirmation to be entitled to request the Grant on behalf of institution (as identified above) / I, the applicant, herewith confirm that I am entitled to request and obtain the 350 Research Grant funding on behalf and for my employer / institute and to have obtained all necessary employer approvals. / ☐Yes
☐No
☐N/A
Agreement on the terms and conditions / I, the applicant, herewith confirm to have read and understood the terms and condition of attached to this application form and I agree to be bound by its Terms and Conditions. / ☐Yes
☐No
Data Privacy Information
Merck KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany, uses your personal data collected in this form for evaluating your application, including to contact you via phone or e-mail(Art. 6 (1) b) General Data Protection Regulation), to track repeat and multiple applications from the same applicant, and to use this information to prepare a 350 Anniversary Research Grant Agreement (contract) between a research institution you are affiliated with, and Merck KGaA, Darmstadt, Germany, in the event that your research proposal is selected for the 350 Anniversary Research Grant. We process the information you provide, in accordance with our Privacy and Cookie Policy. By providing the above information, you consent to such processing and you warrant that all information you provide about yourself is true, accurate, current and complete. Furthermore, you confirm that you obtained the explicit consent of any other persons whose personal data you may provide. You understand that transmission of information via the internet is not completely secure and is not encrypted; Internet or phone service providers are third parties used for delivery of the messages therefore you understand that transfer of messages via these communications channels are subject to their own terms and conditions.
Your personal data will only be shared by us with Merck KGaA, Darmstadt, Germany affiliates and partners, including, but not limited to an independent review committee evaluating your application for the purposes of such evaluation. Where we share your data with recipients outside of the EU, we conclude standard contractual clauses ("Clauses") issued by the EU Commission to safeguard your data.
You have a right to receive and inspect your stored personal data, to demand its correction or deletion, to object to its future use and to receive copies of the Clauses, for example by contacting our data protection officer ().We will keep your data as long as we may collaborate with you (now or in the future).
Signatures:
Name of Applicant in printed letters: Click or tap here to enter text.
Date: Click or tap here to enter text.
Signature:______
(If applicable)
We have read the Terms and Conditions and herby consent to such:
Name of Institution:Click or tap here to enter text.
Date:Click or tap here to enter text.
Title and name of Institute representative:Click or tap here to enter text.
Signature:______
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