asrf application form

ASRF PROPOSAL APPLICATION FORMInnovation Grant Scheme

Revision 6.2, Jan. 2012

TABLE OF CONTENTS1. Introduction and Funding Conditions ........................................................................................................ 3 2. Cover page .................................................................................................................................................. 4

Title of the research proposal ....................................................................................................... 4 Project Acronym ............................................................................................................................ 4 Project summary ........................................................................................................................... 4 Organization that administers the research grant details .............................................................. 4 Research team ............................................................................................................................. 5 Classification of grant proposal / research field ............................................................................ 5 Proposal keywords ........................................................................................................................ 5 Fund and duration summary ......................................................................................................... 6 Co-funding/ other funding resources ............................................................................................. 6

3. Concept and objective ................................................................................................................................ 7 Introduction ................................................................................................................................... 7 Concept / statement of the problem ............................................................................................. 7 Objectives ..................................................................................................................................... 7 Expected outcomes ...................................................................................................................... 8

4. State-of-the-art ........................................................................................................................................... 9 Literature research ........................................................................................................................ 9 Patents research .......................................................................................................................... 9

5. Implementation and Methodology ........................................................................................................... 10 Scientific methodology and experiments ..................................................................................... 10 Project plan ................................................................................................................................. 10 Project work packages ............................................................................................................... 10 Project milestones ....................................................................................................................... 11 Project schedule ......................................................................................................................... 12 Research team ............................................................................................................................ 12 Research team capability statement ........................................................................................... 13 Facilities, equipment & other resources ...................................................................................... 14

6. Financial requirements and justification .................................................................................................. 15 Budget 15 Other major financial resources .................................................................................................. 17

7. Impact and dissemination ........................................................................................................................ 18 Results dissemination plan ......................................................................................................... 18 Management of intellectual property ........................................................................................... 18 Industrial involvement and exploitation of the results .................................................................. 18 Contribution to community and societal objectives ..................................................................... 18

8. Ethical issues ........................................................................................................................................... 19 9. Certification .............................................................................................................................................. 20 10. Checklist for submitting the research proposal ...................................................................................... 21 11. Reviewers suggestion ............................................................................................................................. 22

Proposal Application Form - Rev.6.2 2 / 22

1. Introduction and Funding ConditionsApplied Scientific Research Fund (ASRF) is an Arabic non-government, non-profit organization, created by Samih Darwazah, founder of Hikma Pharmaceuticals, to foster and enable innovation through various funding schemes for applied researches and commercialization activities as well as to create the culture of research and innovation in the Arab region.

Funding scheme objectives:◦ Support innovative ideas by starting from R&D and focusing on the value of the impact of

the results and finally commercialization◦ Accelerate the commercialization process by moving from the research idea to prototype

Eligibility:◦ Researchers and inventors ◦ Research centers and universities

Conditions to be a candidate project:◦ Quality of scientific proposals and contribution to science◦ Technical feasibility of the project◦ Market potential and feasibility ◦ Clear, tangible and measurable outcomes◦ Impact and quality of the prospected results

ASRF’ Support (up to 100,000 JD over 2 years) that can include:: ◦ Material and equipment◦ Research and implementation cost◦ Prototype design and development◦ Full lab-scale demonstration and technical testing◦ Material and implementation costs◦ Technical and prototype testing◦ Conducting field studies

Intellectual Property ownership:◦ ASRF owns the resulting IP◦ ASRF and the inventor share royalty from sales/commercialization according the

agreement signed between the two parties

Contribution to ASRF and /or the community:◦ The team agrees to provide technical reports and progress on their project at regular

predefined intervals (quarterly every 3-6 months) based on the support/funding agreement.◦ The team agree to deliver public training/workshops on their technical field of expertise as

it relates to the research that is equivalent to 1 day public workshop/training◦ Agreeing to press and promotion as part of the ASRF marketing and communication

campaign, with teams prior approval of content.


2. Cover page

Title of the research proposal

Concise & descriptive title (No more than 20-25 words)

Project Acronym

Project summary

(1 page max)

• Include a self-contained description of the activity that would result if the proposal is funded. Include a statement of objectives and methods to be employed.

• Summarize project goals and expected outcomes, including how they pertain to broader impacts.• Describe specific goals, methodology, long-term objectives, expected results

Organization that administers the research grant details

Organization’s Name Division or DepartmentTitle & Name of Head/Chairman (Authorized representative of the organization)CityCountry AddressPhoneFaxEmail of the contact personWebsite


Research team

Investigator/researcher1 Name Title/Position Institute3

PI (Principle Investigator)Co-I 1 (Co-Investigator)Co-I 2 (Co-Investigator)Co-w1 (Co-worker)2

Co-w2 (Co-worker)Note1: Only PI & Co-I are considered to the IP (Intellectual Property) rightsNote2: Co-workers (employees or contractors) may be determined later after the grant/fund is approved. Co-workers are not considered to the IP (Intellectual Property) ownership rightsNote3: The PI (Principle Investigator) must be affiliated with the organization that will administer the grant

Classification of grant proposal / research field

Classify your proposal under each of the following areas. (Multiple fields can be selected but indicate the main field with “M”)

Acronym Scientific Area Field SelectionAF Agriculture, Food and Fisheries SciencesBT BiotechnologyCI Chemical Industries

DM Drugs & MedicinesEE Electrical & Electronics Technologies EG Energy (including renewable energies)EN Environment, (including Climate Change)HE HealthcareIT Information and Communication Technologies

MC Mechanics & ConstructionNN Nanosciences, nanotechnologies, materials & new

production technologiesNS Natural / Pure scienceSE Security and SafetySH Socio-economic Sciences and the HumanitiesTT Transport & logisticsWA Water, Waste & UtilitiesOT Other: Please specify

Indicate research subfields

Proposal keywords

To facilitate selection of evaluators / indexing / promotion/ etcProposal Application Form - Rev.6.2 5 / 22

Fund and duration summary

Requested Fund amount (in JOD)(10 to up to 100K)1

Project Duration (in Months) (6 to 24 Months) 1

Note1: Justification must be provided for requested funds more than 100K JOD or more than 24 Months and will be subject for approval by the fund management and the evaluation committee

Co-funding/ other funding resources

Is this research proposal co-funded by other agency? If yes please attach the funding agreement and the proposal (will be considered in the evaluation)


3. Concept and objective

Introduction

Provide a basic but thorough introduction to your subject. Don’t expect reviewers to be familiar with your field so you should include clarifying information for your project. Reviewers are an intelligent, yet diverse audience. State your overall vision and motivating rationale. What is lacking? Provide background and need/significance. Do you have preliminary results?

(one page max)

Concept / statement of the problem

• State the problem that you are trying to solve• State limitations of existing/current solutions and how such problems are solved or worked

around with existing technologies

* Be sure to cite any references mentioned in the Project Description.

(Two pages max)

Objectives

State main objective of the proposed research and its significance

(One page max)


Expected outcomes

(DISCUSS ALL FOLLOWING 5 POINTS)

• Research project outcome(Provide specific, measurable outcomes)

• Novelty and innovation(Explain any new features or approaches in your research work)

• Beneficiaries of the results and how they might utilize the results. (Avoid the obvious general benefits and focus on specific, measurable benefits)

• Prospects for a commercial potential. (New applied ideas, new technologies, new applications, prototypes, startups, etc.)

• Patents and papers

(Four pages max)


4. State-of-the-art

Literature research

• State cites references related to this project• Critically analyze relevant and recent literature with a point of view of defining what has been

done and what is needed

(two pages max)

Patents research

State published patents related to this project (You can use the following links for patents search)

• http://www.google.com/patents • http://www.wipo.int/pctdb/en/ • http://www.epo.org/searching.html • http://ipco-jo.org

(one page max)


http://ipco-jo.org/

http://www.epo.org/searching.html

http://www.wipo.int/pctdb/en/

http://www.google.com/patents

5. Implementation and Methodology

Scientific methodology and experiments

Explain the scientific methodology and suggested experiments and procedure

(two pages max)

Project plan

• Describe on a high level the followings: (more details in next section)

• Describe the project Activities and its relation and effectiveness in achieving the project goals.

• Describe the time plan

• What facilities and resources are available and how they are going to be used?

• Include for each Objective of the project: (1) Methods/Activities (2) Expected Results/Deliverables (3) Limitations & alternatives & (4) Timeline/Resources if needed

Project work packages

Organize the activities to achieve the project in work packages with clear description, actions, durations and expected deliverables. Link the work packages to project objectives

(THIS SECTION WILL BE UPDATED, CONSIDERED AND ATTACHED TO THE FUNDING AGREEMENT)

Work Package Title Duration (months) Expected End DateWP1WP2WP3


Work Packages Description1

Work package no.Work package titleExpected Starting date WP DurationResearcher No. PI Co-

I1Co-I2

Co-I3

Co-w1

Co-w2

Co-w3

Person-months per researcher2

Objectives

Description of activities (possibly broken down into tasks) and role of partners

Deliverables and expected outcomes

Note1: Include separate table for each work packageNote2: If a researcher is not participating in this work package add 0 under his/her number

Project milestones

(THIS SECTION WILL BE UPDATED, CONSIDERED AND ATTACHED TO THE FUNDING AGREEMENT)

Milestone no. Milestone name WPs involved Expected date1

M1M2

Note1: Researchers will be compensated upon completion of each milestone

Milestone no.

Means of verification1

M1M2

Note1: Describe how the milestone achievement will be measured or verified (for example, achieved certain tests, delivery of prototype, buying equipment, etc.). Should be measurable to be included in the grant contract


Project schedule

Start date and durationProposed start dateDuration of the project in months

Timeline

Work Package

Months2 4 6 8 10 12 14 16 18 20 22 24

WP1

WP2

WP3

Research team

(THIS SECTION WILL BE ATTACHED TO THE FUNDING AGREEMENT)

Principal & co-investigators summaryPrincipal Investigator (PI) Details

Title and PositionFirst NameLast NameOrganizationDivision or Department AddressMobile PhoneFaxEmailWeb

Co- Investigator 1 Details1


Title and PositionFirst NameLast NameOrganizationDivision or Department AddressMobile PhoneFaxEmailWebNote1: Include table for each Co-Investigator and co-worker if knownNote2: Co-workers are employees/contractors and do not share the IP ownership

Research team capability statement

• Describe the competencies and skills of the research team why they are suitable for the project and can achieve it.

• What are Previous researches conducted by the investigator(s) in the project proposal field• What are their publications and patents in this field, Provide most significant and recent

publications, fellowships/contracts awarded, papers presented• What other/previous research projects the team members have managed• Please attach the CVs of the research team

(4 pages max for the whole team) PI:

Co-I1:

Co-I2:


Facilities, equipment & other resources

Describe the facilities, labs, tools and equipment to be used in the project

Equipment Code

Equipment Name Location1,3,4 Accessibility2,3 Cost of use

Eq1Eq2

Note1: Where is this equipment physically located in the country of research (which institute, department, etc.). Note2: Are there any specific accessibility conditions or requirementsNote3: If the equipment is not available in the country of research indicate thatNote4: If the equipment is located in the institute that administers the grant will be part of the institute participation in the project

Equipment Code Time of use1 Justification of use2

Note1: For how long this equipment will be used Note2: Why this equipment is needed for the project


6. Financial requirements and justificationBudgetProvide detailed budget for first 12 months and estimates for all following years (submit detailed budget each year)

Budget summary

Item Amount Year 1

Amount Year 2

Note

EquipmentHuman Resources (manpower)Travel * only to access equipment, facilities or do some tests outside the research locationDissemination (Patents, etc.) * papers/conferences are not coveredMaterial / ConsumablesServices

Manpower expenses(SUBJECT TO APPROVAL AND SPECIAL CONDITIONS MIGHT APPLY IN THE GRANT AGREEMENT)

Position No. Monthly Rate (MR)

Duration of Involvement in months (DOI)

% of Full Time subtotal Cost JOD(No x MR x DOI x %)

Research assistant

Total


Travel expenses (EACH TRIP MUST BE DIRECTLY APPROVED BY THE FUND MANAGEMENT 90 DAYS BEFORE THE TRAVEL)

To From Purpose of travel days Ticket DailyLodging

Subtotal

Total Travel Expenses

Consumables expenses

Description Qty. Unit(kg. m, pack, …)

Unit Price

Subtotal

Total

Equipment cost(SPECIAL CONDITIONS IN THE GRANT AGREEMENT MIGHT APPLY FOR PURCHASING THE EQUIPMENT) Equipment code

Country of Origin

Delivery Time

Qty. Unit Price Import duty Tax Subtotal

Eq.1

Total

Services/facilities give details of needed facilities

Description Proposed Usage Cost

Total

Other items (e.g. dissemination) Proposal Application Form - Rev.6.2 16 / 22

Description and Justification Cost

Total

Other major financial resources

Support for this Projects from other sources

Funding Agency

Amount in cash

Amount in kind

Funded activities

Please provide the followings: (COPIES OF ALL DOCUMENTS MUST BE ATTACHED)• Funding agreement(s) and proposal(s)• IP ownership of the results• Stage of development / progress• Research results reports


7. Impact and dissemination

Results dissemination plan

How will results be broadly conveyed? Patents, spin-off companies, papers, special seminars, etc.

(two pages max)

Management of intellectual property

How the results will be protected, managed and shared among team, institutes and funders

(one page max)

Industrial involvement and exploitation of the results

How will you exploit the results, who might be interested (industry, companies, institutes, etc.) in the results and do you have clear plan how to involve the industry(one page max)

Contribution to community and societal objectives

Describe how the results of the project will have impact on some or all of the followings

• Quality of life• Health and safety• Employment• Environment

(two pages max)


8. Ethical issues

Please complete the form “04 Ethics Checklist.docx”


9. Certification

In submitting this research proposal, we confirm on behalf of the Administrative Authority of the submitting organization(s) and partner organizations that:

• The information in the proposal submitted is true and complete.• The proposal idea is original and the result of intellectual activities of the PI and Co-Is• The research is scientifically applicable and has potential for industrial application• The Team (PI & Co-Is) are responsible for the delivery of the stated work packages, milestones

and the expected results • The team is responsible to report the achievements and resulted IPs to the granting institute

Name Signature Date

Principal Investigator

Person in Charge of Authorizing Organization as Host for Project Co-Investigator 1

Co-Investigator 2

Co-Investigator 3


10. Checklist for submitting the research proposal

Item Yes NoCover PageConcept and objectiveState-of-the artImplementation and methodologyFinancial requirements and justificationImpact and DisseminationEthical IssuesCertificationNot exceeded the page limitationCo-funding documents attached


11. Reviewers suggestionCould you please suggest 3 referees, reviewers or experts in the field of your research to consult for the assessment?

NameOrganization’s Name Division or DepartmentCityCountry AddressMobile PhoneFaxEmailWebsite



Applied Scientific Research Fund (ASRF) Email: [email protected] Tel: +962-6-515-5095 Fax: +962-6-516-1399


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