DER CPER CTRL 2014-2020 Centre Transdisciplinaire de Recherche sur la Longévité Call for Projects 2016 Application form The admissibility of the application will be evaluated based on information given on the application form and provided by the applicant. Incomplete applications will not be considered nor returned. Please fill precisely the set of elements presented below. 1. General Information If more than two teams are involved in the project, please duplicate the tables CPER CTRL Project Acronym Title of the project (English) Titre du projet (Français) Team 1 - CPER CTRL Project Coordinator First name and name Title/Position UMR / Laboratory Partner institutions (UMR/laboratory) Postal Address Phone number e-mail address 1 Team 2 - CPER CTRL Project Partner First name and name Title/Position UMR / Laboratory Partner institutions (UMR/laboratory) Postal Address Phone number e-mail address Team members implicated in the CPER CTRL Project Team 1 - CPER CTRL Project Coordinator Name and first Name Institution(s) Title/Position Number of personmonths dedicated to CPER CTRL Project Duplicate lines if necessary 2 Team 2 - CPER CTRL Project Partner Name and first Name Institution(s) Title/Position Number of personmonths dedicated to the CPER CTRL project Duplicate lines if necessary For each Principal Investigator (CPER CTRL Project Coordinator and CPER CTRL Project Partner): Curriculum vitae List of peer-reviewed articles of the 5 last years, including patents and grants obtained as main investigator for this period (with grant titles and funding instrument) 3 2. Research project - 10 pages maximum Acronym : Title of the project (English): Titre du projet (French): Scientific Abstract – English (max 250 words) Public Abstract - English (max 250 words) justifying the project on longevity research Résumé public - Français (max 250 mots) expliquant la relation du projet avec la recherche sur la longévité 4 Detailed CPER CTRL Research project Precise description of the CPER CTRL research project workpackages description, impact) including a short bibliography (objectives, (word times 12, single spaced) Future research and perspectives (max 250 words) 5 3. CPER CTRL Project Gantt chart Summarizing the project (workpackages/main steps of the project for each team involved) 4. CPER CTRL Project Budget Maximum budget allocated: PROJECTS “CTRL COLLABORATIFS”: 200 000 € maximum - 24 months (equipment, consumables, personnel costs including post-doc) PROJECTS “CTRL EXPLORATOIRES”: 50 000€ maximum - 12 months (consumables only) “POST-DOCTORANTS CTRL” : 114 000 € Post-Doc position - 24 months (personnel costs only) Budget Total Year 1 Year 2 Comments Not applicable to Projects “CTRL Exploratoires” and “CTRL Post Doc” Equipment (>500 € per item) Personnel costs Not applicable to Projects “CTRL Exploratoires” Other costs including: Not applicable to Projects “CTRL Post Doc” - Consumables Internal invoicing (IPL) Sub-contracting (Travel costs not eligible) Year 2 budget not applicable to Projects “CTRL Exploratoires Budget justification: Describe budget needs for the execution of the CPER CTRL Project by each team in terms of: 6 - Equipment: - Personnel : - Other costs including: o Consumables o Internal invoicing (IPL) o Sub-contracting (Travel costs not eligible) 7 5 Signed agreements CPER CTRL Project Principal Investigators (Project Coordinator and Project Partner, Research Unit Directors, Team Leaders) Acronym : Title of the project (English): Team 1 – CPER CTRL Project Coordinator CPER CTRL Project Coordinator Name Signature Team Leader (if applicable) Name Signature Director of Research Unit Name Signature Team 2 - CPER CTRL Project Partner CPER CTRL Project Partner Name Signature Team Leader (if applicable) Name Signature Director of Research Unit Name Signature 8 The complete application must be assembled as a single document. Contact person: Fabienne Jean [email protected] Deadline: October 3, 2016 *Three hard copies of the application, received October 3, 2016 at the latest, to the attention of : Pr. Patrick BERCHE Directeur Général Institut Pasteur de Lille 1 rue du Pr. Calmette BP 245 59019 LILLE cedex *An electronic copy (WORD + PDF version) before October 3, 23h59 sent to : [email protected] [email protected] Please use the following name for electronic documents: Projects CPER CTRL Collaboratifs: “CPER CTRL_Coll16_acronym_coordinator name” Projects CPER CTRL Exploratoires: “CPER CTRL_Expl16_acronym_coordinator name” Projects CPER CTRL Post Doc: “CPER CTRL_PostD16_acronym_coordinator name” 9
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